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Discover how leadership coaching sessions reinforced partnerships between public health and community-based organizations.

Learn how boundary spanning leadership can help develop more robust and productive public health workplaces.

Developing Executives Leading in Public Health (DELPH) is a leadership development program that increases and strengthens participants’ visibility and exposure in public health systems, access to key networks, and leadership development opportunities.

DELPH Reflections: A Journey Towards Creating a More Equitable and Just Democracy Fredrick Echols DELPH has helped public health professionals reflect on their purpose, cultivate compassionate leadership, understand system dynamics, and build a community of advocates to create a more equitable and just democracy. As an African-American male living in the United States, I have encountered numerous obstacles in life, particularly in my efforts to reform systems that fail to support marginalized and vulnerable populations. These systems have had devastating effects on myself and other individuals belonging to Black, Indigenous, and People of Color (BIPOC) communities as they restrict access to essential health and social services. As a Black physician and public health professional, I continue to encounter this stark reality that engenders a sense of hopelessness in communities across the United States. These systems obscure their true intentions and deceive individuals into believing that they operate in the best interest of marginalized populations while perpetuating inequitable and disparate health outcomes. In consideration of these personal and professional experiences, the Diverse Executives Leading in Public Health (DELPH) program has played a significant role in shaping my career and purpose: Fostering Critical Reflection: It provided me with a journey that encouraged me to think critically about my future and how I can leverage my platforms and relationships to help propel the public health ecosystem toward a system that embraces the humanity of all individuals and prioritizes uplifting and empowering the most vulnerable and marginalized populations. Important note: That said, the presence of silos, political posturing, and missed opportunities due to inefficient and ineffective operational practices resulting from insufficient fiscal investment continue to plague the public health ecosystem—limiting its ability to make strides toward a system that wholeheartedly supports the pursuit of health equity and social justice. Cultivating Compassionate Leadership: The program also provided access to experts and public health thought leaders who helped my colleagues and I understand the evolution of health and social service delivery in the United States (particularly for indigent populations), increase our capacity to embrace divergent thinking, and engage in constructive dialogue. The availability of such a space provided us with an opportunity to establish a secure and conducive environment, one that upheld the virtues of compassionate leadership and fostered effective relationship building. Our ability to engage with stakeholders, both like-minded and those with differing opinions, was characterized by a spirit of intentional listening that sought to comprehend their perspectives. Through this, we were able to create an atmosphere that supported open dialogue and nurtured mutual understanding. Understanding System Dynamics: The experience has enriched my comprehension of the intricacies that drive the amplification of inequality and the resulting health disparity gaps that are pervasive among communities and individuals across the nation. The knowledge thus obtained is of paramount importance to ensure my competency in identifying and avoiding perpetuating the issues that I aspire to address. This, in turn, will prevent any inadvertent harm to the communities I seek to uplift and empower. Building a Community of Advocates: Moreover, the program has enabled me to connect with individuals who are unwavering in their commitment to upholding justice. Despite our diverse backgrounds, we set aside cultural differences to work toward a common goal: the accessibility of quality healthcare and the delivery of justice for all humanity. The DELPH program's fundamental principles and culturally sensitive support structure have played an instrumental role in shaping my professional growth as a public health expert. As I chart the course for my future professional endeavors, I intend to leverage the lessons learned and the tools provided by DELPH to strengthen the public health ecosystem. My ultimate goal is to foster collaboration across various segments of society to create a more equitable, just democracy. The DELPH program has equipped me with invaluable knowledge and skills that will enable me to make meaningful contributions to society's betterment. For this, I express my profound gratitude to the Association of State and Territorial Health Officials, the Morehouse School of Medicine's Satcher Leadership Institute, and CDC for their unwavering commitment to advancing BIPOC leadership in public health. Their steadfast support for this program has enabled me and countless others to acquire the skills and knowledge necessary to effectively lead and drive the transformative change that public health requires. I sincerely appreciate their continued investment in this vital initiative, which has empowered many to become the change agents that public health needs. website yes

Get insight into the successes and challenges of integrating race/ethnicity data in public health and future directions in this field.

Building More Equitable Communities Through Public Health Law Dawn Hunter Every week, my husband and I place a grocery order. We shop at an employee-owned supermarket chain known for its workplace culture. Sometimes we order online and pick it up, sometimes we have it delivered, and sometimes we do the shopping ourselves. In any case, we often purchase our groceries without much thinking—if we order online, we are prompted to “buy it again” and even in person we tend to buy the same staples. Prices are higher online than in store. In addition, we live in a community where plastic bags are still an option, but we used to live in a community where plastic bags are banned. Why am I sharing all of this? Nearly every aspect of our weekly grocery trip is shaped by the law. Laws impact: Food placement, packaging, expiration dates, and prices. Employee wages and benefits. Store location, hours, and accessibility. Availability of rideshare drivers for delivery orders. Whether to choose paper or plastic. Law impacts the way we experience our everyday lives by establishing the framework in which we operate. The grocery store is just one example of how law can shape our decisions and, more importantly, our choices. Because it shapes the resources and opportunities available to us, law is an important determinant of health. Exploring the Landscape of Public Health Law What we think of as “law” can take many forms. It includes statutes, regulations, case law, organizational policy, and budgets, and how they are interpreted and enforced. The law can be a set of requirements or prohibitions, establishing norms and expectations for our behavior as individuals, organizations, and systems. The law can also be the processes and procedures associated with creating laws, making decisions, and interpreting existing laws. Public health law, specifically, is important as a field because it includes the laws that are designed to protect and promote the public’s health and that define the power of the government to act on our behalf. In fact, law is behind every public health success of the 20th century. A 1999 issue of the Morbidity and Mortality Weekly Report listed vaccinations, motor vehicle safety, safer workplaces, healthier moms and babies, and recognition of tobacco as a health hazard among those successes. These achievements would not be possible without the law, including: School vaccination laws. Helmet and seatbelt laws. Speed limits. The Occupational Safety and Health Administration. Food fortification. School lunch programs. The Women, Infants, and Children (WIC) program. Newborn screening. The Tobacco Master Settlement Agreement. Clean indoor air laws. At the same time, these laws have not benefited everyone equally. In fact, they have often operated as a tool of racism and other forms of structural discrimination. The lesson here is that the law can create the conditions that lead to differences in health outcomes, but it can also create the conditions for equity. The Civil Rights Movement and Advances in Health Equity One must look only to the civil rights movement to see the potential. As just one example, today’s robust network of Community Health Centers was born from the activism of the Black Panther Party, which established free health clinics in response to continuing discrimination in the health care system, as well as the work of H. Jack Geiger and Count D. Gibson Jr., who established the first community health centers in 1965. The success of these efforts led to funding for additional community health centers through President Lyndon B. Johnson’s Office of Economic Opportunity as part of his War on Poverty. In fact, key legislation enacted during the civil rights movement led to significant, even if insufficient, improvements in health outcomes for Black Americans. For example, there is evidence that women’s suffrage, the Civil Rights Act of 1964, and the Voting Rights Act all led to improvements in premature mortality and infant mortality, among other benefits. The enactment of the Patient Protection and Affordable Care Act in 2010 and the resulting adoption of Medicaid expansion saw similar success. There is ample evidence of the Medicaid expansion impact on health outcomes and financial well-being, both at the individual and population level. Addressing the Training Gaps in Public Health Law for More Equitable Public Health Practice The fact that law shapes how we experience our lives on a day-to-day basis is perhaps the most important reason that public health professionals should understand the relationship between the law and health outcomes and how to use the law to achieve more equitable, thriving communities. However, knowledge of public health law continues to be one of the biggest training gaps in the public health workforce. The 2021 Public Health Workforce Interests and Needs Survey, conducted by the de Beaumont Foundation and ASTHO, found that strategic and systems thinking was one of the top training needs as well as an increased interest in policy engagement and topics related to justice, equity, diversity, and inclusion (visit the 2021 Dashboard). Another report in 2021, “Challenges and Opportunities for Strengthening the US Public Health Infrastructure: Findings From the Scan of the Literature” by the National Network of Public Health Institutes, found a need for increased awareness among the public health workforce of the legal basis for public health authority and identified both how to influence law and policy development and how to understand the effects of law and policy on health among the top training needs. These findings align with public health accreditation standards. Whether or not you work for an accredited health department, the Public Health Accreditation Board Standards and Measures serve as a guidepost for the practice of public health. There are two specific domains where this is relevant: domains 4 and 5, as detailed in Table 1. Padding Block - Medium(10) Table 1. Public Health Accreditation Board Guidance for Equity Domain Measure Examples Domain 4: Strengthen, support, and mobilize communities and partnerships to improve health. Measure 4.1.3 A: Engage with community members to address public health issues and promote health. Making the decision-making structure inclusive and transparent to empower community members or developing mechanisms for shared ownership in the process. Enhancing residents’ capacity to understand levers of power or influence in policy change. Domain 5: Create, champion, and implement policies, plans, and laws that impact health. Measure 5.1.2 A: Examine and contribute to improving policies and laws. Assessment of the impacts of the policy or law on equity. Input gathered from stakeholders or strategic partners. Padding Block - Large(2) Lessons Learned: Involving and Empowering Communities The inclusion of community members in assessment, decision-making, and capacity-building efforts to understand levers of power or influence reinforce key lessons learned in the past three years, spurred by COVID-19 and the racial justice movement of the summer of 2020: The first lesson is the need to recognize and rectify historical injustices. It is important that we understand the historical legal context behind current health inequities. We must know and name the problem to solve it. The second is the need to rectify current inequities by analyzing and assessing the ways in which our current system of laws is creating and reinforcing inequities. The third is the need to engage impacted people in identifying, designing, and implementing solutions. One of the lessons learned from the work of Geiger and Gibson was that there is a difference between what the health system thinks people need and what communities think they need. It seems we are still trying to learn this lesson today. Leveraging Law to Drive Equity and Make Public Health More Trustworthy Law is the only way to truly change the game for inequities. It can give a voice to historically marginalized people by creating pathways to ensure inclusion and representation in the political process. It can also change systems and institutions by changing the way they operate and the way that people within those systems operate. Additionally, it can serve as a tool to enforce conditions that will lead to more equitable outcomes and to hold people in positions of power accountable. We have often heard in the past few years about the need to rebuild trust in public health. I’d like to reframe that to think about how we make public health as a field more trustworthy. It starts by increasing our understanding of the authority of public health to promote the public’s health and to use that authority to create systems in which we all can thrive. article yes

Though now an illegal practice, government contracts, policies, and practices have generally excluded women, and Black, Indigenous, and people of color. Still, practices and existing structures continue the inequitable distribution of all contracts. Governmental and non-governmental grants and funding should benefit the communities they serve while being proportionate to the communities' demographics. This is where inclusive contracting comes in.

It has never been more important for public health to better understand the disability community and quickly build skills and resources to better serve them, which makes it critical to include more people living with disabilities in the public health workforce.

As in any sector, there is often talk in the public health field of “working upstream,” or addressing problems at their source. If public health is going to be a changemaker in the world, its leaders must be equal parts nimble and innovative.

Five great reasons to attend ASTHO's 2023 Health Equity Summit.

An issue that public health wrestles with is how to combat racism as we would any other public health emergency. ASTHO’s board of directors has declared structural racism a public health emergency. And health equity is the number one priority in ASTHO’s strategic plan, which means our staff will prioritize equity work as we support all aspects of our members’ technical assistance and capacity building needs.

Amid so much uncertainty, it might feel naïve to make any claims about what the future holds. But it is in these moments that it becomes more important than ever to have beacons to guide us and give us hope. As we look ahead to 2022, here are four priorities that must steer the public health course in the year to come.

Every year on Nov. 22, ASTHO—and countless other agencies and organizations worldwide—take a moment to acknowledge the public health workforce on Public Health Thank You Day. Like so many other days of recognition, it has become a blip on our yearly calendar. And, simply put, that’s just not enough. This year, ASTHO leadership took pen to paper to share some of our feelings, fears, and—yes, our thanks—for everything the public health workforce has always done to protect us.

ASTHO CEO Michael Fraser, PhD, and Tracey Wareing Evans, President and CEO of APHSA, sit down to discuss building a foundational family well-being roadmap amidst the COVID-19 pandemic.

When rural hospitals close, it increases the distance people must travel for essential healthcare services. The COVID-19 pandemic has highlighted and magnified the factors leading to rural hospital closures across the country. Many healthcare facilities suspended elective procedures to conserve critically needed personal protective equipment and reduce the risk of exposure to COVID-19 by patients and hospital staff. For many rural hospitals, however, the suspension of elective procedures with the reduced the use of non-urgent services by apprehensive patients meant a loss of revenue and the furloughed healthcare staff. Since the onset of the COVID-19 pandemic, approximately half of all rural hospitals are experiencing negative operating margins due to reduced outpatient revenue. The rate increases in states that have not expanded Medicaid. Unfortunately, these kinds of challenges are not new to rural hospitals.

Over the years evidence has expanded on community health workers (CHWs) improving outcomes and even reducing disparities in heart disease and many other public health priority areas. However, their presence in state and local public health workforce is still modest. A number of efforts have sought to expand the role of CHWs in medical care settings by developing reimbursement through third party payers, along with including them in managed care contracts and incorporating them in state Medicaid plans. The experience and lessons of the COVID-19 pandemic could substantially change the way we practice public health in the future, and provides opportunities to expand the role and presence of CHWs in the state and local public health workforce.

How Staffing and Workload Can Impact Public Health Agencies Kelsey Tillema Public health is combating burnout and high turnover by focusing on key practices to improve workforce infrastructure—learn more in this blog post. Public health agencies often face significant challenges managing workforce priorities related to staffing and workload. While these issues are not new, the COVID-19 pandemic underscored the importance of retaining the public health workforce as a critical component of emergency response. A lack of capacity to manage an agency's workload can create a toxic cycle, often negating any impact of positive organizational culture improvements. In turn, productivity diminishes, turnover increases, and the remaining workforce suffers. To combat this pattern of inadequate staffing and attrition, a robust combination of effective recruitment, timely hiring practices, equitable workload policies, pay considerations, and skilled leadership to champion changes are essential. With one in three public health employees considering leaving their organizations within the next year—citing pay, work overload and burnout, lack of opportunities for advancement, stress, and organization culture as top reasons for leaving—retaining employees in public health has never been more important. As demonstrated during the COVID-19 pandemic, a lack of solid workforce infrastructure and workload imbalance among health care professionals and public health employees can have disastrous consequences for the workforce and overall public health. According to an analysis by the de Beaumont Foundation, “state and local health departments need to hire a minimum of 80,000 more full-time equivalent positions (FTEs)—an increase of nearly 80% —to provide adequate infrastructure and a minimum package of public health services.” As challenges and uncertainties continue to arise in an ever-changing public health landscape, quickly filling open positions and retaining current public health professionals is a key strategy to ensuring a healthy workload balance among teams and programs. Timely recruitment and hiring practices, creative recruitment strategies, broader job requirements and qualifications, as well as conducting capacity and project prioritization assessments can help alleviate stress and burnout that existing employees may experience due to open roles or understaffing. Chronic understaffing and delays in filling positions can contribute to stress, burnout, and higher turnover due to employee dissatisfaction. While an agency can have meaningful organizational culture and well-being initiatives in place, understaffing and workload imbalances can quickly counteract these efforts if not addressed quickly. Policies such as providing additional pay to employees who are taking on extra duties due to unfilled positions, cross-training or cross-skilling across duties and/or programs, assessing team and individual workloads, as well as providing avenues for staff to work toward promotions when taking on work that isn’t normally part of their role can motivate employees who are asked to take on more than their job description outlines. One such framework in discussion at North Dakota Department of Health and Human Services is a creative take on a career ladder—called a “career honeycomb.” In contrast to the ladder framework that typically reflects straight upward career growth, the honeycomb is a bi-directional opportunity to look at career development from various angles. The desire is to increase employee retention and satisfaction by providing avenues for staff to receive bonuses or other incentives for taking on extra work, earn “points” toward specific career milestones or promotions, be recognized on various platforms by their colleagues and leadership team, and embed their workforce development plan and mentorship program opportunities into the various “cells” of the honeycomb. This kind of creative thinking is an innovative way to holistically address both the agency’s and individual’s needs and strengthen overall workforce development. When understanding and implementing effective hiring policies and ensuring equitable workloads across a public health agency, human resource and workforce development/well-being teams are a crucial component. An internal team that is dedicated to assessing employee capacity, hiring and promotion policies, well-being, and overall organizational culture can help mitigate burnout among staff, lower turnover rates, and ensure wise use of resources. By continuously evaluating both the staffing needs and the overall health of the organization, HR and workforce development professionals can foster an environment that attracts and retains top talent, leading to improved job satisfaction and agency performance. The relationship between staffing, capacity, and workforce culture in public health agencies is undeniable. Ensuring that there are timely and efficient recruitment and hiring practices in place, equitable workload policies, and advancement opportunities can foster a healthy and effective workforce. These efforts must be supported by a dedicated team of workforce development and human resource professionals who regularly focus on assessing and addressing workforce staffing, capacity, well-being, and organizational culture. By prioritizing these internal needs, agencies can break cycles of burnout and turnover to create a resilient and capable workforce that effectively responds to public health challenges. OE22-2203 PHIG article yes

ASTHO placed 14 disability and preparedness specialists in health agencies to support inclusivity of people living with disabilities during the COVID-19 pandemic and beyond. In this brief, three of these specialists share their experiences with ensuring COVID-19 vaccination sites are accessible to people living with disabilities. They share their perspectives and recommendations for expanding vaccine site accessibility.

Leading from the Inside: Advancing DEI at the State Level astho, association of state and territorial health officials, workplace cultures, financial performance, creates a positive, diversity equity and inclusion dei, united states, work life balance, hiring process, human resources, organizational culture, top talent, team members, employee engagement, recruiting process, long term, public health worker, socioeconomic status, races ethnicities, retain employees, company s culture, diversity equity inclusion, public service, recruitment retention development, public health workforce, work culture, organizational values, diversity matters James Bell III Three steps on how to implement DEI strategies at the organizational level. Campaigns for racial justice have grown throughout our country, and parallel conversations focusing on diversity, equity, and inclusion (DEI) have increased, especially in public service. We experience this effect through the lens of facilitating more equitable and responsive service delivery. Our programming, policies, and data must be culturally informed and relevant. But DEI must also be valued internally in how we contribute to employee recruitment, retention, and development. Today’s workplace is complex, and DEI is vital for improving outcomes for all the populations we serve. Most modern organizations have come to terms with the critical need for DEI initiatives. The evidence highlighting how these efforts can improve an organization’s productivity, creativity, retention, and financial success has been clear for some time. But, honestly, is that enough? And why haven’t we made the earth-shattering changes we all know are possible? Perhaps it could be traced back to the changes we hope to seek being assigned outside of our organization when it should be us who are leading and implementing change. Breaking down siloes for diversity requires new ways of working with fewer barriers among and across teams and their unique people. To remove these perceived barriers, I propose that a few key steps must take place. 1. Put the people first. I have been in too many meetings where employees are considered “resources” or “FTEs,” and it’s so unfortunate. As advantageous as it may be for some, the lure of DEI as a return on investment cannot be the sole purpose for pursuing such initiatives. We lose the essence of humanity and unique individuality that makes diversity so special when we limit people to a box on an organizational chart. If governments want to attract and retain the best possible talent, the actual business case to make is talent itself. Building a diverse and inclusive culture cannot only be a human resources function or a top-down effort. All people across departments should see themselves reflected in this work and be able to identify a path to make it their own. As leaders, we should work relentlessly toward understanding the needs of others while building a safe environment for the type of collaboration needed to solve complex problems better. This means constantly learning and embracing new concepts, ideas, and ways of doing things. Each of us has the power to create a more substantial, fairer workplace where everyone can contribute their strengths, talents, and ideas while being treated with dignity and respect. 2. Back your program with a budget. Organizations have shouted their pledges and promises to foster more diverse, equitable, and inclusive environments from any rooftop they could find for at least three years. Although determining which groups are walking the walk is challenging, a strong indication of one’s commitment is to look at budget line items. A lack of or limited budget is an immediate red flag that conveys that DEI is not a priority. Just like anything else, if something is important to you, you will spend the money required to implement it properly. One of the best ways to demonstrate your commitment to DEI is through sustainable, tangible financial investment. This allows our DEI initiatives to be continuous and to evolve over time based on the immediate need. We are not in a position to check the box or allow one implicit bias course to cover all the broad gaps we are experiencing. There is also the benefit of a broad supply of qualified DEI practitioners and consultants who are experienced in guiding organizations through complex DEI issues. Should we continue to face complicated and longstanding DEI issues, it isn’t up to our staff to try to resolve them. We must assign monthly, quarterly, or annual monies to address these problems. 3. Hold yourself and your organization accountable. Regardless of agency or size, DEI efforts within organizations often lack strategic follow-through and accountability. These endeavors are often reactive, episodic, or only prioritized after a public relations crisis. We can’t only respond when we are required to respond. The communities we serve—and our employees—expect that we will carry out our responsibilities and fulfill our promises. We have not consistently been diligent in creating mechanisms for feedback, and if we have, we fail to implement them. To truly embed DEI into our culture, we need meaningful metrics and the willingness and courage to use the data to hold ourselves accountable. How will we ever know if we are going in the right direction or making desired changes if we never discuss the data? And that isn’t to say results must be perfect because we know changes take time. But it communicates clear goals and allows for solid focus and discussion for alignment. This disclosure is necessary to drive change and inspire others by demonstrating that progress is possible. The future of state government must fully embrace diversity, equity, and inclusion both as an aspiration and as a responsibility. We must create a sense of belonging and environment for organizational justice, even if this means resisting the status quo that we have nurtured and become far too comfortable letting stand. We should be celebrating rather than marginalizing employees because of their individuality. We should be challenging business practices that undermine our organizational values and fail to treat employees equitably. Author card spacing 1 Related Content-Blog - DELPH Magazine 2 website yes

What We Learned at the Public Health TechXpo and Futures Forum ASTHO | Our staff's top takeaways from the TechXpo. astho, association of state and territorial health officials, public health techxpo and futures forum, public health leaders, u.s. public health system, public health policy, data sharing and modernization, population health, governmental health agencies, public health infastructure, workforce resilience, public health workforce, techxpo and futures forum, public health infrastructure, build workforce resilience, future of public health, health techxpo and futures, health leaders and experts, experts across the technology, health workforce, health outcomes, futures forum, health leaders, health departments, public health professionals, today and the future, public health services, public health techxpo Dylan Reynolds Marcus Plescia and Garfield Clunie present "The Future of Measuring Health Equity - A World of Evolving Data." Last month, ASTHO kicked off the Public Health TechXpo and Futures Forum in Chicago, an opportunity for some of the world’s top leaders in technology and to engage public health leaders on challenges and solutions for successfully modernizing the U.S. public health system. Over 600 participants were in attendance, with 200 more attending virtually from around the world. It was a packed three days. Our speakers demystified the world of public health policy, opened doors to new funding streams, and gave us a glimpse into the glittering future of data sharing and modernization. Heavy hitters from Amazon and Google weighed in as well, showing us how they’re working hand-in-hand with health agencies to change the way they approach population health and well-being. So as we look back on a busy week—and look ahead to our virtual follow-up event on June 15—here are some of the messages that stuck with us the most: "Standards are like toothbrushes. Everyone has one, and no one wants to use some else’s." The line from Gabriel Seidman, director of policy at the Ellison Institute for Transformative Medicine, was met with a belly laugh from a crowded room during one of the week’s most well-attended sessions, a panel conversation on the future of measuring health equity. However, Seidman’s comparison was an apt one. There is certainly much to be said for a public health data system that is engineered to meet the specific needs of its target community. However, for public health experts to do their best work, they must be able to speak a common language—at a local, state, territorial, and national level. When each level of public health is operating with different standards in place and with a different definition of success, data gets lost and people get left behind. One of the loudest calls to action from the week was for governmental health agencies to break down these data siloes and establish common standards between agencies. The "Next Pandemic" is a Priority—But It's Not the Only One There is—understandably—mounting national attention on preparing for what many public health experts believe will be the inevitable "next pandemic." The COVID-19 pandemic showed us what a lack of preparedness could mean for population health, and there is so much unknown about what the future of pandemics has in store. However, experts at the TechXpo reminded us that public health is about more than responding to a singular crisis. "I think many of the conversations we're having are so focused on COVID-like pandemics," said John Auerbach (alumni-MA) "But if we look at the things that are still killing people, for the most part it's not infectious disease." Instead, Auerbach cited challenges that have long been a part of the public health story, such as diabetes, the fentanyl overdose crisis, and climate change. Before COVID-19 entered the national spotlight, public health’s day-to-day work was largely centered on chronic disease and behavioral health. Auerbach reminded us that amid all of the unknowns of our future, there is plenty we do know—and plenty we can be doing to address it. "Modernizing data systems is more than buying a big computer." While there were many versions of this message over the course of the forum, Auerbach perhaps said it most concisely of all. In other words, it doesn’t matter if a public health agency has a chrome-plated exterior and a cloud-based data system, so long as the underlying infrastructure isn’t sustainably and thoughtfully built. Whether it’s a matter of restricted funding, antiquated processes, or siloed thinking, health agencies and their leaders must have a plan to address these challenges before assuming that “buying a big computer” will catch their data dashboards up to speed. This was one of the ironies of this future-forward event: Amid so many exciting innovations and inventions, many of the challenges boiled down to basic, equity-centered questions about the best way to get this new technology in the right people’s hands. If public health is going to take a technological leap at a national level, then it must also be able to make a leap at a community level—in communities of color, in territorial health agencies, and in our policies. Jumping lightyears ahead doesn’t count if entire populations are still being left lightyears behind. Workforce Resilience Cannot Be Taken for Granted We cannot separate the future of public health from the future of its workforce. The COVID-19 emergency response has left many public health workers feeling burned out and harboring traumatic levels of toxic stress, pushing many of them to seek out jobs outside the field. In fact, according to a recent analysis of data from the Public Health Workforce Interests and Needs Survey, 46% of state and local public health employees left their jobs between 2017 and 2021. For public health to reach its full potential in the future, we must begin investing in that workforce today. Over the course of the week, we heard often from mental health experts and senior health officials to learn about their priorities, challenges, and paths to improve workforce well-being in their health agencies. This included the unveiling of the PH-HERO Workforce Resource Center, which arms health agencies with the resources and knowledge they need to support their workforce. Whatever the future of public health holds, it begins with a workforce who is motivated to make that future a reality. More than anything, the TechXpo was a reminder that public health’s future is as multiple as it is uncertain. We are working toward a future that is more adaptable than ever before—with thought innovators and health experts who are constantly reflecting, pivoting, and adjusting to the moment. There are so many conversations yet to be had. For those who have not done so already, we invite you to register for our fully virtual TechXpo follow-up forum on June 15, and add your voice to the growing chorus. website yes