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The Key Role of Cross-Sector Partnerships in Navigating Barriers Keon Lewis Community partnerships are critical to public health's mission to promote optimal health for all — learn more. Public health departments’ mission and vision statements often share certain values and goals aimed at improving the public’s well-being. Rather than just reactively responding to immediate health threats as they come, public health departments aim to take a more proactive approach through strategies that prevent the future spread of diseases, injury, or other incidences of harm. These actions support their visions of creating communities where all residents can thrive and achieve their full health potential. Strong community partnerships are critical to public health departments’ ability to fulfill their goals. Recognizing this, the Robert Wood Johnson Foundation introduced the Culture of Health Framework in 2015. As a leading national philanthropic organization focused on dismantling barriers to optimal health for all, the framework’s foundation is built upon the following action areas: Making Health a Shared Value. Creating Health. More Equitable Communities. Strengthening Integration of Health Systems and Services. Fostering Cross-Sector Collaboration. The COVID-19 pandemic and its aftermath underscored the factors that created challenges to health outcomes for underserved communities; it also demonstrated the importance of sustaining strong cross-sector partnerships. Public health’s ability to align its goals with the community it serves is vital to efforts to save lives. This alignment allows public health departments to leverage the diverse resources and lived experiences that community partners bring. Recognizing the unique concomitant relationship that it has with government funding, public health departments are now going to have to pivot their strategies to achieve their missions. As public health departments experience budget and personnel cuts, its ability to promote optimal health for all and mitigate the social determinants of health is now even more reliant upon the strength of collaborative partnerships. The Public Health Paradox Public health has always been a component of our nation’s health care system, which primarily reflects specific health issues that have impacted our communities. Rather than focusing on the foundational issues that exacerbate these long-term gaps in underserved communities, government systems often allocate funding based on specific diseases or chronic health issues impacting community health. Although diseases and chronic health issues are significant public health elements that need to be addressed, there are significant nonmedical factors that play just as vital a role in influencing community health outcomes. Identified by the World Health Organization (WHO) and adopted by CDC as the social determinants of health, these variables — which include elements such as social and community construct, economic stability, and education access — have become the central driving force of public health. “The Public Health Funding Paradox,” an article from Sage Journals, offers a great perspective on how an intriguing paradox has been created due to this relationship between public health and government systems. The article underscores the complexity of governmental funding that helps to advance public health strategies while there still exist harmful policies that create barriers for certain communities. The Flint water crisis in Michigan demonstrated this paradox. Flint citizens experienced lead poisoning and death from Legionnaires’ Disease, underscoring how a community’s ability to thrive can be quickly impacted by economic difficulty and leadership decisions made by the accompanying government. The Power of Partnership Public health has long had to combat a barrage of stigmas and policy hurdles. Even at the height of the COVID-19 pandemic, public health departments were not only in contention against the virus but also against the influence of viral misinformation that questioned their practices, strategies, and purposes. Despite these barriers, the nation witnessed the power of true cross-sector partnerships. Health care and grassroot organizations quickly found common ground to help address the needs of underserved populations. From addressing food insecurity to mental health and transportation barriers, communities successfully pivoted toward hope and found ways to save lives. Nonprofit organizations also created innovative and impactful peer-to-peer funding models that enabled them to fulfill their missions in spite of budget cuts. During this time, community health workers became a vital public health resource. As conduits between departments and local communities, community health workers became a necessary element to re-reestablishing trust in systems and care. Although the work of frontline workers and support staff served a critical role in mitigating the future spread of COVID-19, advocates and allies at the grassroots level also played an invaluable role in promoting health for all. As “The Public Health Funding Paradox” demonstrated, public health departments are only as effective as their accompanying government systems. If the leadership within these respective systems fails to align and empathize with their public health counterparts, then as a community we inevitably repeat a vicious cycle that results in poor health outcomes. Identifying Alternative Routes Cross-sector partnerships serve a vital role in enabling public health systems to better serve their communities. Budget cuts and stricter policies have created barriers for local and statewide agencies, academic institutions, and nonprofit organizations. The ability to develop essential personnel, continue pertinent research, and utilize mitigating practices have been inhibited by these barriers. It has become increasingly evident that, rather than focusing on reactive strategies, public health must go upstream and address the social needs of our communities. With cuts to funding, public health systems have to do more with less, making it more difficult to address diseases and chronic health problems. Working upstream to address root causes of health outcomes is one way to better leverage thinner resources. As our public health systems continue to work diligently to monitor, support, and mitigate community health barriers, there is still more research needed to explore the most effective cross-sector partnership frameworks. Public health’s efforts must remain intentional in developing comprehensive health advisory coalitions, leadership development cohorts, civic and community engagement projects, and paradigm shifts in academic curricula. The leaders and changemakers of tomorrow require growth in their competencies today. Cross-sector partnerships must continue to build their foundations upon systems of trust and transparency. Public and private health systems, the social sector, and other community stakeholders can partner to improve the population’s overall well-being while simultaneously achieving a mutually beneficial “social return on investment.” Public health’s ability to align with the achievement of optimal health for all requires more than just serving on the front line when a crisis occurs — it is critical that these departments must continuing enhancing their collaborative partnerships and community engagement. article yes

Learn how public health leaders can lead through crisis and support their teams in this blog post.

Understanding Digital Accessibility Before the ADA Title II Deadline Emily Lapayowker, Adrianna Evans With the ADA Title II deadline looming, learn how to prioritize and improve digital accessibility on your agency’s website. Digital accessibility ensures the digital world is usable for everyone. And while it is an increasingly prominent topic in public health, there is still much to learn. This resource can help public health agencies understand digital accessibility basics and promote accessible communications for the disability community, which is typically underserved in public messaging. Government Laws and Requirements ADA The Americans with Disabilities Act is a federal civil rights law that prohibits discrimination against and requires equitable access for people with disabilities. ADA’s connection to digital accessibility may not be immediately apparent, but digital accessibility is covered under the large umbrella of equal access to public areas that ADA guarantees. In fact, Title II of ADA enforces digital accessibility compliance by requiring state and local government websites and digital tools be accessible to people with disabilities — the Department of Justice has announced a compliance deadline of April 24, 2026, for jurisdictions of 50,000+ people and April 26, 2027, for smaller entities. Sections 504 and 508 Section 504 of the 1973 (Vocational) Rehabilitation Act requires any entity that gets federal funding to provide equal access to electronic information technologies for people with disabilities. Section 508 requires the federal government to meet those same standards. These sections were initially written in 1998 and then updated in 2018 to include requirements for mobile technology. WCAG Is the Industry Standard The Web Content Accessibility Guidelines, or WCAG, is published by the World Wide Web Consortium (W3C), an international organization that establishes open web standards. WCAG is currently in its second version. When evaluating compliance, there are three different WCAG conformance levels: A (lowest), AA (middle), and AAA (greatest). Interestingly, W3C recommends that all web-based information aim to hit AA because it is not possible for some types of content to reach AAA compliance. WCAG 3.0 is currently in development and expected to be a major paradigm shift. POUR Principles WCAG standards are principle-based, which means that rather than requiring all web browsers to meet a specific technical standard, WCAG requires that digital content adheres to the POUR principles. All four principles focus on the user’s experience: Perceivable: All information must be presented in a way that ensures users can perceive it using at least one of their senses. Operable: A website is considered operable if all users can effectively navigate it, even those who employ assistive technology, such as screen readers. Understandable: This is a two-pronged principle — users must be able to understand how to use a site and understand its content. Robust: Content must be robust enough that multiple technologies, including assistive devices like screen readers, can interpret it. These laws and guidelines are minimally prescriptive to promote longevity. Remaining principle-based rather than tech-based means these standards will not become obsolete as technology advances. Where and How to Make the Biggest Impact Health agencies can make small changes to digital content in a few key places that will make a world of difference for users with visual, hearing, physical, and cognitive disabilities. Some examples include emails, PDFs, website and social media content, and staff resources. Link Smart and Sparingly Screen reader technology allows low-vision users to navigate webpages and other digital content in a variety of ways. One is by jumping from link to link without referencing the content around that link. So, make your linked text descriptive enough to stand on its own. Also, avoid typing out URLs whenever you can — screen readers will read aloud the URL as phonetically as possible, which is not a great user experience. Additionally, when a screen reader reaches a link in the content, the software will announce it. Use links sparingly to avoid major disruption to the reading experience, as over-linking can make it hard to keep track of the content. Use the Built-In Text Styles Document hierarchy is another essential part of accessibility remediation. The built-in font styles, such as headers and lists, are for more than just aesthetic — screen readers use these styles to navigate Word documents, PDFs, and webpages. Use headers in order (i.e., never skip a heading level), and deploy ordered and unordered lists thoughtfully. For example, if you list specific steps in a process, use an ordered list. If you list symptoms of a viral infection, an unordered list is a better fit. Use Color and Contrast Correctly Do not rely on color alone to convey important information, because users with low vision or colorblindness may have trouble differentiating between different colors or shades. Best practice is to use additional visual markers to signal the presence of important information and ensure there is at least a 3:1 contrast ratio for graphics. Follow Alt Text Best Practices Screen readers read alternative text (or alt text) to allow users with visual or specific cognitive disabilities to understand the content and purpose of an image, table, or informational graphic. Some alt text best practices: Be succinct. The ideal length is between a few words and a couple of short sentences (use the average length of a post on X as a guide, about 250 characters). The goal is to be brief but still convey the image’s vital information. Avoid phrases like “image of” because screen readers will identify all images as such, which makes this redundant. The context around the image is just as crucial as the alt text. If there is already a detailed description of a virion’s shape in the document's body, repeating all that information in the alt text is unnecessary. Not all images convey information. In those cases, it’s important to use null alt text, which will let assistive technology know that the image is decorative. To do this, either add “decorative” in the alt text field, or mark it as decorative in the platform, if that option is available. When creating complex images such as charts or graphs, communicate what the graph is telling users rather than just what it looks like. Learn More There is a whole world to learn about within digital accessibility, but there are resources and experts to help. You can connect with internal experts on your IT team or external disability and accessibility organizations for support. You can also learn more about digital accessibility at the following resources: Introduction to the Americans with Disabilities Act by U.S. Department of Justice. Civil Rights Division Section 508 (Federal Electronic and Information Technology) by U.S. Access Board What Is Plain Language? by Plain Language Action and Information Network Constructing a POUR Website by WebAIM WCAG 101: Understanding the Web Content Accessibility Guidelines by Level Access Glossary of Disability-Related Terms by University of Washington Accessibility Online by Great Lakes ADA Center Related Content-Blog - DELPH Magazine 4 article yes

Learn how Delaware leveraged online tools to improve collaboration between partners working to reduce heart disease in the state.

Rethinking “Soft” Leadership Skills in Public Health Rethinking “Soft” Leadership Skills in Public Health Angela Cochran, Jamilia J. Sherls Learn how public health leaders can leverage interpersonal skills to better navigate cross-sector partnerships in this blog post. Budget reductions, staff lay-offs, conflicting federal guidance, limited funding opportunities, being asked to do more with less — these are just some of the challenges public health professionals navigate. Public health’s goal to promote health, safety, and wellness across the nation is difficult to achieve while negotiating these challenges, often leading to stress and burnout. According to the 2024 Public Health Workforce Interests and Needs Survey, approximately 71% of state and local government public health workers are experiencing at least one symptom of burnout and about 20% are experiencing near-constant symptoms. When stress creeps into collaborative spaces, it can lead to frustration, misalignment, poor decisions, strained relationships, and weakened outcomes. As leaders work with internal teams and external partners to achieve public health goals, they must remain vigilant for signs of stress impacting the work. Stress often presents as irritability, conflict, errors, and stagnation. When stress gets in the way, it is critical for leaders to tap into their “soft” skills to alleviate pressures and create a clear path forward. Across sectors, communication, empathy, adaptability, and critical thinking are often grouped under the label “soft” leadership skills. Soft skills are considered foundational, interpersonal qualities or skills that help individuals interact with peers and navigate complex work environments. They may also increase resiliency, which is important in today’s ever-changing world. The term “soft skills” may sound neutral, but it carries an implicit assumption that these skills are easier, less rigorous, or secondary to technical expertise. These are, in fact, the skills that most define the quality of a leader. In practice, they are the very competencies that determine whether collaborative efforts succeed or stall. While there are many “soft” skills or leadership practices that can be helpful in stressful partnership situations and reducing conflict, there are three leadership habits especially critical to sustaining collaboration: Practice Intellectual Humility. Intentionally Build Psychological Safety. Anchor Communication in Values, Not Reaction. Each of these habits is learnable and, when applied with intention, can shift the entire energy of a room. Practice Intellectual Humility Collaborative leadership requires the ability to rethink assumptions without abandoning core values. In cross-sector work, leaders frequently navigate different perspectives, competing priorities, and incomplete information. Approaching these situations with a fixed mindset or rigid assumptions can limit progress, while intellectual humility creates space for better solutions. Practicing intellectual humility does not mean being easily persuaded or lacking confidence. It means remaining open to new information, asking thoughtful questions, and recognizing that no single perspective fully captures the complexity of the issue. Leaders who model this behavior create environments where others feel more comfortable contributing ideas, raising concerns, and engaging in meaningful dialogue. This becomes especially important when partnerships, both internal and external, are under strain. As expectations shift or challenges emerge, the ability to pause, reflect, and reconsider can prevent unnecessary conflict and support more productive problem-solving. For example, in cross-program initiatives where teams bring different priorities or funding requirements, taking time to understand competing perspectives before moving forward can prevent misalignment and strengthen long-term collaboration. Intentionally Build Psychological Safety Effective collaboration depends on trust, but trust does not develop passively. It must be built intentionally through leadership behaviors that create psychological safety. In practice, this includes clearly defining roles, maintaining open communication, and creating space for respectful disagreement. Proactive relationship management, such as regular check-ins and early disclosure of challenges, is essential to maintaining alignment and preventing breakdowns in collaboration. Without these efforts, stress can quickly erode trust and lead to disengagement. At the local level, building psychological safety often requires visible leadership behaviors that demonstrate support rather than control. This can include showing up alongside teams during outreach efforts when additional support is needed, not to direct the work but to reinforce shared ownership and trust. It also involves intentionally creating space for team members to share perspectives and acknowledging when or how those perspectives shift your own thinking. For example, when team members raise concerns or offer alternative approaches, responding with openness, such as acknowledging a perspective that had not been previously considered, can reinforce that you value their input. Over time, these behaviors help establish an environment where staff feel more comfortable speaking up early, allowing leaders and teams to address challenges before they escalate. Leaders play a critical role in shaping this environment by normalizing open dialogue and demonstrating that they value differing perspectives. Anchor Communication in Values, Not Reaction In fast-paced and often high-pressure environments, it can be easy for communication to become reactive. However, reactive leadership can create confusion, erode trust, and shift focus away from shared goals. Anchoring communication in shared values provides consistency and clarity, particularly when navigating uncertainty or competing demands. This means responding thoughtfully, aligning messaging with the broader mission, and maintaining transparency even when challenges arise. For example, during executive leadership discussions involving shared funding opportunities or cross-agency initiatives, leaders may face competing priorities and uncertainty around ownership of the work, responsibilities, or decision-making authority. In one discussion regarding a collaborative grant opportunity, a leadership team navigated tensions by grounding the conversation in organizational values that had been intentionally developed through prior team building, reflection, and difficult conversations around how the group wanted to lead and work together. Because there was already a shared understanding around values such as honesty, respect, integrity, trust, and clarity, team members felt comfortable asking difficult questions openly and respectfully. Rather than reacting defensively or avoiding tension, the leadership team was able to clarify expectations, define roles, and move forward with greater alignment and confidence. Listening to partners and stakeholders remains essential, but listening does not require immediate agreement or action. Leaders must balance openness with discernment, ensuring that decisions remain aligned with both evidence and organizational values. This approach reinforces stability within partnerships and helps to sustain collaboration over time, even when external pressures are high. Applying these three leadership habits the next time you feel the room get tense will significantly improve group dynamics, allowing the team to focus on the tasks at hand. It is important that leaders understand these practices require intention, consistency, and reflection. After an event, leaders should take time to think and reflect on how they used these practices, what the immediate outcomes were, and if there is anything different they would do the next time. These leadership habits do take practice, so leaders should be patient with themselves as they get more comfortable applying them in the heat of the moment. As the great philosopher Epictetus said, “It’s not what happens to you, but how you react to it that matters.” Public health is truly in unprecedented times, bringing with them unpredictable, challenging, and nuanced situations. Leadership calls for not only “technical” expertise, but for “soft” expertise as well to manage stress and complexity, provide clarity, and achieve the best possible outcomes in collaborative spaces. Resources PH WINS 2024 Findings by de Beamount Soft Skills Matter Now More Than Ever, According to New Research by Harvard Business Review Intellectual Humility by Character Lab Values-Based Communication (PDF) by TCC Group What Is Psychological Safety at Work? Here’s How to Start Creating It by APA Reviewed by - Mason, Prather article yes

Six DELPH scholars share personal reflections about LGBTQ+ identity, representation at work, and how allyship within public health leadership is critical when responding to a crisis.

ASTHO asked six DELPH scholars to reflect on their DiSC assessment results and how they use the findings to tap into their leadership influence and impact.

ASTHO invited five DELPH scholars to provide examples of how community and diversity shape their leadership within their local health department and share recommendations for a more inclusive workplace.

In this blog post, six DELPH scholars share their thoughts on what it means to have influence as a leader and the individuals that have most influenced their leadership styles.

ASTHO interview with T Benicio Gonzales and Shelley J. Lee, members of the first DELPH cohort, about their leadership journey.

An interview with Luci Longoria and Lt. Commander Traci Murray, members of the DELPH program's first cohort.