NACCHO, ASTHO, and the Surgeon General: Partnering to Build Healthier, More Resilient Communities

By Kevin G. Sumner, MPH, NACCHO President and Health Officer and Director of the Middle-Brook Regional Health Commission in Green Brook, New Jersey

This year, NACCHO is collaborating with the Association of State and Territorial Health Officials (ASTHO) and the Office of the U.S. Surgeon General on the ASTHO President’s Challenge. ASTHO President Nicole Alexander-Scott, MD, MPH, Director of the Rhode Island Department of Health, U.S. Surgeon General Jerome Adams, MD, MPH, and I have united to call on state, territorial, local, and tribal health officials to build healthier, more resilient communities by supporting investments in community-led, place-based approaches. The challenge has two specific goals: (1) equipping health officials to mobilize community-led, place-based collectives focused on measurable outcomes to build stronger communities; and (2) connecting public health officials, and their communities, to business leaders and policymakers who want to invest in these community-led, place-based approaches and advance economic development by reaching across sectors.

The challenge’s community-level approach makes local health departments (LHDs), and thus NACCHO, a natural partner for ASTHO. As LHD leaders and staff, we know the strengths and challenges of our communities better than almost anyone else and have the knowledge and local connections to make the goals of this challenge a reality. ASTHO will coalesce health officials and other partners at the state level to share best practices and build momentum across the nation. Finally, the Surgeon General is able to influence federal policy and bring awareness to the important work that is happening locally. In addition, the Surgeon General has identified economic prosperity as an important public health initiative, which aligns with this challenge. The partnership among our three organizations will broaden the scope of our activities and multiply the returns of this work.

The first goal of the challenge, which many LHDs are already actively engaged in, focuses on empowering communities to solve the health challenges they face. As LHD leaders, we can engage in this work by stepping outside the walls of the health departments and connecting with local community leaders. We can help these leaders understand the local public health research, frameworks, and best practices that will strengthen community health improvement initiatives. And, we can mobilize the networks we have developed over years of practice to support and drive these initiatives. When these relationships are created thoughtfully and intentionally, LHDs will prove themselves to be indispensable partners in these community-led efforts.

The second goal of the challenge focuses on engaging policymakers and business leaders to improve community health and resiliency. Small or poorly funded LHDs may find this goal more challenging due to a lack of resources, particularly the human resources that may be required to develop new partnerships. On the other hand, larger, more resourced departments may also find it a challenge as it may be a newer activity that they have not felt the need to engage in as much as others may. No matter the circumstance, this goal is essential, as many policymakers and business leaders do not always understand how public health touches everything in their communities. Policymakers want to see an immediate return on investment and oftentimes do not recognize the immense long-term value that public health provides. When it comes to engaging local policymakers, NACCHO has a variety of resources that LHD leaders can use, such as policy statements on a wide variety of issues and guidance about the differences between education, advocacy, and lobbying. Many times, building relationships with policymakers can be as simple as inviting them to visit your agency. In my health department in New Jersey, I’ve had success in inviting our local elected officials and business administrators to an annual meeting where we highlight public health issues that demonstrate the breadth and depth of the work that we do. This challenge calls on us to redouble our efforts in building and sustaining these relationships with local decision-makers.

As noted, this second goal also speaks to the value of public health officials engaging business leaders to foster investment in community health initiatives. As the boots on the ground, local health officials understand that public health affects nearly every aspect of community life. However, we’re not always effective in communicating to businesses how public health initiatives affect their bottom line. In framing the message, we must demonstrate the ways in which local investments in public health create healthier workers, cutting health care costs and increasing productivity for employers. The Surgeon General, whose motto is “better health through better partnerships,” is currently producing a report that will demonstrate the connection between economic prosperity and community health and is seeking to foster private-sector investment in local public health initiatives. The report will provide new insight into the ways public-private partnerships can create healthier, more vibrant communities. It will also help LHDs understand how to build these connections. In fact, the Surgeon General requested input specifically from local health departments during an open comment period earlier this fall.

I want to note that this challenge is not just for large, well-resourced LHDs. I represent a small health department and am intimately familiar with the personnel and funding challenges facing our smaller health departments. Despite those challenges, I believe there is room for us in this challenge. Facing the financial and human resource constraints that we do, many of us have already started to forge non-traditional partnerships as a matter of survival. These partnerships allow us to extend the scope and reach of our work in ways we would never be able to alone. We may in fact be able to inform some of our colleagues in larger departments who have historically not been so dependent upon others for assistance.

I am incredibly excited about this challenge and I look forward to seeing the fruit that this initiative will bear. It will likely take more than one year to see the results of this challenge, but NACCHO continues to be well positioned to serve as the voice of LHDs and will seek out and disseminate best practices to support all of us on this journey. I look forward to joining you all in rolling up our proverbial sleeves and getting to work.

To learn more about the ASTHO President’s challenge, listen to episode 11 of the Public Health Review Podcast at