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Learn more about DELPH Cohort 3 participants.

Learn more about DELPH Cohort 5 participants.

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.

Learn more about DELPH Cohort 4 participants.

To learn more about how the DELPH program has influenced our scholars’ leadership journey so far, ASTHO spoke with three leaders in the current cohort: Andrea Lowe, director of legislative services at the Nebraska Department of Health and Human Services; Tiffany Wilson, data analytics branch manager at the Alabama Department of Public Health; and Harold Gil, data science support unit supervisor at the Washington State Department of Health.

An interview with DELPH scholars Halina Palacios and Nathifa Miller about the importance of developing a strong leadership style, advice for future public health leaders, and using the DiSC Personality Assessment.

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.

A Q&A with DELPH participants James Bell III and Sandy Noel about their experiences in the program and why it is so important to develop your own brand as a leader.

ASTHO Announces Sixth Developing Executive Leaders in Public Health Cohort ARLINGTON, VA — Today, the Association of State and Territorial Health Officials (ASTHO) announced its sixth cohort of Developing Executive Leaders in Public Health (DELPH). This highly competitive program began in 2021 and continues to strengthen the leadership capacity of mid- to senior-level governmental public health professionals. “I am thrilled to welcome the sixth cohort of the DELPH Program,” says Avia Mason, ASTHO vice president for leadership and learning. “This group of 20 scholars brings exceptional dedication and passion to the work of public health, and we are honored to support their journey as they strengthen their leadership, expand their impact, and improve the health of their communities.” Cohort six scholars include: Faisal Adam, DC Health Department Vina Ayuyu, Commonwealth Healthcare Corporation Misty Carney, Maryland Department of Health Colette Cobb, Office of the California Surgeon General Angela Cochran, St. Mary's County Health Department Jessie Fernandes, Montana Department of Public Health and Human Services Tynisha George, Chicago Department of Public Health Ethan Greenblatt, St. Louis County Department of Public Health Gabby Hadly, Snohomish County Health Department Shebra Hall, Delaware Division of Public Health Brandon Horvath, Philadelphia Department of Public Health Halana Kaleel, Austin Public Health Markeeta Keyes, City of Minneapolis - Health - Green Career Exploration Aracely Macias, New Jersey Department of Health Chelsea Moriarty Coffield, Harris County Public Health Natasha Pickens Shumpert, Jefferson County Department of Health Dipa Shah, Los Angeles County Department of Public Health, Nutrition and Physical Activity Program Jamilia Sherls, Washington State Department of Health Iliana Siarmalis, Maryland Department of Health Tenneh Turner-Warren, Arizona Dept of Health Services ASTHO continues its commitment to developing, elevating, and modeling strong leadership for the next generation of emerging public health leaders. At a time when public health demands courageous vision, strategic action and collaborative strength, programs like DELPH are more essential than ever. Through an innovative, cohort-model, participants will deepen their leadership identity, enhance their communication, and grow their ability to positively influence their organizations. Each participant is matched with an executive coach, accountability partner and DELPH team member for personalized, transformative leadership development. “Morehouse School of Medicine is proud to continue its partnership with ASTHO in facilitating the DELPH program,” says Sandra Harris-Hooker, senior vice president for external affairs and innovation and interim director of the Satcher Health Leadership Institute (SHLI) at Morehouse School of Medicine (MSM). “This ongoing collaboration between ASTHO and MSM’s SHLI advances our institution vision of ‘Leading the creation and advancement of health equity to achieve health justice.’ Together, we are equipping and empowering individuals to step into national and global arenas where strong, equity-centered public health leadership is needed most.” With support from the CDC, the success of the DELPH program’s more than 100 alumni demonstrates how strengthened leadership translates into stronger public health systems as they take on the pressing challenges facing our communities. Cohort six scholars will kick off their programming on December 8 in Arlington, VA. ASTHO Press Release Boilerplate website yes

ASTHO Leaders Selected for de Beaumont Foundation’s 40 Under 40 in Public Health ARLINGTON, VA—Today, the de Beaumont Foundation announced its 40 Under 40 in Public Health class of 2023, a national recognition for leaders changing the field of public health. One state health official, an ASTHO staff member, and three Diverse Executive Leading in Public Health (DELPH) scholars were selected for the list. The recognition acknowledges the achievements of exceptional public health professionals and highlights ASTHO's role in cultivating visionary leaders. ASTHO-affiliated selections include: Paula Tran, state health officer and administrator, Division of Public Health, Wisconsin Department of Health Service. ASTHO staff member Alicia Justice, senior director, Programmatic Health Initiatives and Strategy DELPH scholar Dr. James Bell III, state assistant administrator, Michigan Department of Health and Human Services. DELPH scholar Heather Pangelinan, director, Public Health Services, Commonwealth Healthcare Corporation DELPH scholar Dr. Eric Tang, public health medical officer, STD Control Branch, California Department of Public Health “I’m thrilled to see ASTHO leaders once again represented on the de Beaumont Foundation’s 40 Under 40 in Public Health list," says ASTHO CEO Michael Fraser, PhD. "This honor showcases their commitment to fostering healthier communities and driving positive change on a national scale." “The professionals chosen for the 40 Under 40 in Public Health Class of 2023 demonstrate the determination, commitment, innovation, and resilience of the public health field,” said Brian C. Castrucci, DrPH, president and CEO of the de Beaumont Foundation, which launched the program in 2019. “Their work is strengthening communities and improving lives, and I look forward to following their careers and learning from them.” The nominees represent 21 states and one territory and were selected by a distinguished panel of public health leaders and de Beaumont Foundation staff. It is the third installment of the list, which launched in 2019. The nominees come from a diverse range of backgrounds and professional roles. The 40 Under 40 list also honors nine other state health department staff members, including: Kara Buru, South Carolina Department of Health and Environmental Control Shelly Choo, Maryland Department of Health Shamaree Cromartie Jones, Virginia Department of Health Mallory Cyr, Association of Maternal Child Health Programs Jervelle Fort, South Carolina Department of Health and Environmental Control Stacey Kallem, Philadelphia Department of Public Health Carolyn Rhodebeck, New York City Department of Health and Mental Hygiene Katrina Saphrey, Virginia Department of Health, Crater Health District Julian Watkins, New York City Department of Health and Mental Hygiene Learn more about the 40 Under 40 in Public Health honorees. ASTHO Press Release Boilerplate website yes

On January 16, 2024, ASTHO and the Satcher Health Leadership Institute (SHLI) at Morehouse School of Medicine unveiled the latest cohort of 15 mid-to-senior level governmental public health professionals selected for the Diverse Executives Leading in Public Health (DELPH) program.

Two DELPH scholars from cohort one reflect on their completion of the 10-month program and discuss how learning about one’s own leadership style is critical for success.

Four DELPH participants answer the question, “Which is more important for leadership in health equity: to influence the community to follow the leader’s vision or to influence the community to follow their own vision?”

Learn how public health leaders are redefining leadership and building more collaborative, sustainable systems.

Exploring the Effect of Public Health Crises on Health Equity Leadership ASTHO, association of state and territorial health officials, public health, social determinants of health, centers for disease control, public health crisis, health disparities, health crises, health leaders, health departments, public health professionals, health leadership, achieve health equity, advancing health equity, health equity, public health crises, public health leadership, covid 19, covid-19 pandemic, public health leaders, health equity leader ASTHO Staff ASTHO | DELPH scholars reflect on the impact of the COVID-19 pandemic on public health leadership. Health equity is at the center of the Diverse Executives Leading in Public Health (DELPH) program. ASTHO, in partnership with the Morehouse School of Medicine’s Satcher Health Leadership Institute, challenges DELPH scholars to reflect on what it takes to bring this equity work to their own health departments. Given the unique circumstances presented over the past few years by the COVID-19 pandemic, ASTHO reached out to a few of our DELPH scholars to discuss what type of leader this moment in public health requires and their experience in health equity leadership during the pandemic. In this blog post, DELPH scholars Ryan Natividad, Sounivone Phanthavong, Krystle White, and Felicia Veasey contemplate whether the times produce the leader or the leader produces the times. This conversation continues a discussion held with the same scholars in a post about elevating community voices through health equity leadership. KRYSTLE WHITE: I recently found a quote from Joaquin de Castro, co-founder of MindReform, that stated, “Great leadership arises through the proper action at the proper time,” and I couldn’t agree more. When it comes to being a public health leader and, more importantly, a health equity leader, what is impacting our community the most shapes our efforts. In a picture-perfect world, certain health crisis interventions would not exist if it wasn’t for health leaders responding with innovative tools to combat the issue. Without the severe impact of the COVID-19 pandemic, the way we responded to certain underserved communities would not have been as robust and impactful. The pandemic, along with the layered issue of medical mistrust, forced us to be innovative in our approach when attempting to remedy social determinants of health for certain communities where the pandemic further exacerbated these engrained issues. We had to adjust or redevelop local policies and interventions during this time, as what had worked in the past no longer served those impacted. Effective leaders are tried and tested and can push past difficulties and power forward during some of the tensest times in our history. FELICIA VEASEY: Who I am as a leader now versus who I was before COVID-19 are different. Three years ago, I would have never thought that I could or would serve as the COVID-19 Operations Director for 11 counties while maintaining my role as the community systems director. However, seeing the need of the community, its correlation to chronic diseases, and those most impacted by COVID-19, fueled my desire to lead. I saw the need to lead, in part to speak up for those not around the table making decisions. The pandemic stretched me professionally and spiritually. The ever-changing COVID-19 environment birthed abilities and skills that I didn’t know I possessed. RYAN NATIVIDAD: “Extraordinary times call for extraordinary measures. We saw a need that needed to be filled, and we stepped in to help.” This Benet Wilson quote captures the ardent spirit of my current millennial generation. Among previous generations, millennials are considered the unluckiest generation after surviving various recessions (i.e., the dot-com bubble recession, the Great Recession, and the COVID-19 recession) and powering through the COVID-19 pandemic. Due to these circumstances, I feel that millennials are the “Resilient Generation.” Whatever we endure, we keep our heads high and work towards the future we want. SOUNIVONE PHANTHAVONG: Leaders must be responsive to the environment and conditions in which they are operating. Promoting health equity requires not only an understanding of the structural, social, political, and environmental conditions of health but also the root causes of such conditions. Even with these understandings, well-structured plans are still subject to infinite variables. A leader should be ready to adapt to changes and address emerging needs. A leader working with the times considers what is needed, works towards growth, leverages strengths, identifies opportunities for improvement, provides responsive support, and builds capacity. A leader should aid in addressing conditions that impact the time it takes to make progress towards achieving health equity. A leader who aims to produce the times may face unanticipated challenges that will hinder their ability to achieve their desired outcomes. Systemic issues have limited health equity, with many issues rooted in historical and intentional oppression. These systemic issues require systemic changes. A health equity leader must prepare to work within these systemic conditions to produce macro- and micro-level outcomes. Large Padding 3 Related Content-Blog - DELPH desciption - cake layer website yes

Communication, Community, and Power-Sharing: A Conversation with DELPH Scholars Communication, Community, and Power-Sharing Learn how public health leaders are moving from a top-down approach to a collaborative model that builds and sustains trust with community partners. The current public health landscape can feel daunting, uncertain, and increasingly stressful for leaders to navigate. While public health professionals have a wealth of expertise, reliance on expertise isn’t enough; collaborative leadership points the path forward. Moving away from traditional top-down approaches, effective and innovative leaders are learning to share power, practice meaningful community engagement, and create environments where partners, community, and staff feel valued and heard. Three scholars from ASTHO’s Developing Executive Leaders in Public Health (DELPH) program discuss how they apply these principles to strengthen collaboration within public health and build more resilient communities. Meet the Scholars Working in public health is not individualistic; it requires working collectively to achieve a common goal: healthier communities. These three scholars are championing collaboration. Brandon Horvath, Assistant Program Manager of Preparedness at the Philadelphia Department of Health, believes in the power of collaboration to navigate periods of uncertainty and that moving away from top-down leadership allows space for new ideas to flourish. Ethan Greenblatt, Health Education Supervisor at the Saint Louis County Department of Public Health, focuses on building partnerships to combat misinformation, amplify accurate messaging, and support overlooked populations. Halana Kaleel, Public Health Community Engagement Specialist at Austin Public Health, centers her work on developing genuine engagement between partners before making decisions that impact the collective, emphasizing that participation and power-sharing build trust. “When city council, city management, and other departmental leadership attempt to implement programs, policies, and budgetary changes without doing engagement and collaboration with the impacted community first, they lose trust with the communities we are trying to serve.” — Halana Kaleel Brandon, you oversee emergency communications as part of your role with the Philadelphia Department of Public Health. Can you talk more about the strategies and frameworks you have applied and how they help your team manage complex projects during both emergencies and blue-sky days? BRANDON HORVATH: When deciding how best to infuse collaborative leadership principles into our current reporting structure, I wanted to ground my approach in something relatable that staff would typically associate with comfort and relaxation. That’s when I thought back to the activities that worked best for relieving stress during the COVID-19 pandemic response. In my case, those were running, binge-watching a new TV show, or endlessly scrolling through TikTok. Each of these activities has a few key ingredients in common: time and energy set aside to make the activity happen, and controls to customize the experience. I factored these in when developing two activities that encourage staff participation, collaborative leadership, and feedback. The energy check is a self-reflection activity I like to start off our weekly touch-base meetings with, intentionally setting aside time to highlight accomplishments, discuss challenges staff were experiencing, and set attainable goals and priorities for the next week. Let’s talk it out is a collaborative leadership exercise where staff are encouraged to lead the conversation, using a set of functions you’d find on a remote control: Settings, Pause, Rewind, Fast-Forward, Record, and Power On/Off. The conversation begins with Settings, where we establish ground rules and outline expectations, acceptable behaviors, and how decisions will be made. Regardless of how the activity unfolds, it is important to document what’s discussed, identify any successes or pain points, and work together to draft next steps and potential solutions. Some optional functions can be folded in, depending on time and complexity. Pause (Reflect) involves making space for reflection, which can help ensure continuous improvement and make adjustments easier, regardless of where you’re at in a project. Rewind (What Worked) involves looking back at past decisions or progress since the last check-in, which can help ensure successful strategies are repeated and mistakes are avoided. Fast-Forward (What Do We Want to See) encourages discussion of what you would consider a successful partnership or collaboration. This is especially helpful when a project is complex and involves many stakeholders. Power On/Off (Let’s Revisit This) should be considered when a project is not progressing or we’ve identified pain points that require follow-up. This can bring the conversation to an intentional end, and another time can be set when all involved will regroup and resume planning. The strategies and frameworks you choose to apply will likely vary based on the role you play, the collaborations already underway, and the level of buy-in within your organization or team to shift away from the current project management approach. Ethan, in Saint Louis County your department has utilized community-based partnerships for vaccination efforts and to address the opioid epidemic. How does focusing on building community partnerships help address misinformation, reduce stigma, and increase trust? ETHAN GREENBLAT: Community partnerships allow public health agencies to meet people where they are, both physically and culturally. By working with trusted local institutions and leaders, our partners can deliver public health messages with voices that communities already know and respect. These collaborations also provide valuable feedback that helps programs remain responsive, relevant, and grounded in community needs. Halana, you emphasized that collaborative leadership requires a paradigm shift away from performative community engagement. How can governmental public health agencies transition to power-sharing to rebuild trust with community members who have been historically disenfranchised and excluded? HALANA KALEEL: In discussions with community members and stakeholders, time and time again they saw that they were only being consulted after decisions had already been made. Saying things like, “we want to hear from you” is performative engagement when you already know how you are going to approach an issue. At the end of the day, many communities would rather have honesty about a bad system than feel tricked by tokenistic engagement. To share power with community and stakeholders, governmental public health agencies need to provide opportunities for the communities they serve to participate in decision making at the beginning of the process, and we should empower and hire staff or liaisons who reflect the communities we are trying to reach. We also need to meet people where they are through more informal engagement instead of continuing to force community members who have been disenfranchised to come into governmental spaces that may be hard to reach and perceived as too formal. Lessons Learned and Actionable Advice Reflecting on your experiences, how do you actively build and maintain trust with community partners, staff, and stakeholders? HORVATH: Building and maintaining trust with staff requires leaders to be consistent, reliable, and authentic in their approach. For me, it’s always been about showing up and following through. Creating safe spaces, both formal and informal, where staff can share feedback and ideas, is the first step to making two-way communication happen. Recognizing staff for their accomplishments and highlighting team wins reinforces both trust and integrity. These same approaches can be applied when working in the field or communicating with a variety of stakeholders. GREENBLATT: Building trust requires consistent communication, transparency, and a shared sense of purpose. I focus on developing relationships over time and ensuring our partners feel heard and included in decision-making processes. It is also important that teams and stakeholders align around the organization’s mission, vision, and goals. When partners have a role in shaping the direction of an initiative, they are far more invested in its success. KALEEL: One of my best practices is focusing on closing the feedback loop by showing community members exactly how their input and feedback directly inform final plans and policies. What practical strategies can public health leaders use to strengthen partnerships and build more resilient public health systems? KALEEL: Something that can be daunting, especially during times of uncertain funding, is compensating community for their time and expertise, but this can be something as simple as small stipends, gift cards to local grocery stores, or feeding people at events. HORVATH: Start with a clear purpose. Set aside time to meet with your team to talk not only about what each person will be doing but why it matters. Find ways to infuse collaborative leadership into the culture, such as trying out a new approach to staff check-ins or promoting shared ownership of projects. Most of all, it is important to meet your staff and community members where they are and to be flexible with your approach. Mistakes will happen, but how we learn from them and adapt can help us be more prepared and resilient the next time. GREENBLATT: Public health leaders can strengthen partnerships by being intentional about how they engage with communities and partners. An important starting point is understanding the local landscape — specifically the initiatives, organizations, and trusted leaders in your community — so you can build on what’s already working rather than duplicating efforts. It’s also important to identify shared goals, making

Reprioritizing Black Maternal Health How We Can Prioritize Black Maternal Health Lawrence Young Black women face significant rates of maternal morbidity and mortality — learn how public health can better support them in this blog post. I do not have to look far to understand the urgency of the Black maternal health crisis. I have watched friends, colleagues, and loved ones from every walk of life struggle through pregnancies that should have been safe and celebrated. Some are highly educated professionals. Others are young mothers still finding their way. Many had access to quality insurance and still faced complications, long hospital stays, and minimal follow-up care. Many have shared unfortunate experiences that run the gamut from feeling unheard or perhaps unnecessarily undergoing a procedure — the care in health care was not there for them. These are not isolated incidents. They are part of a larger, structural failure that demands our attention and our action. As public health professionals, we must ask ourselves: How can we better care for and about Black mothers? And what would it look like to center them in the systems that were created to protect women in one of the most vulnerable times of their lives? Understanding the Root of the Crisis Black women in the United States are three to four times more likely to die from pregnancy-related causes than their White counterparts. In many states, including Connecticut, this difference persists even when controlling for education and income. These outcomes are not the result of individual choices or biological differences — they are the result of systems designed with historical blind spots. Education and income, often seen as protective factors, do not shield Black women from these outcomes. Research shows that pregnancy-related mortality rates are higher among Black women with a college degree than among White women with the same level of education or with less than a high school diploma. The same is true for women with respect to the risk of dying within the first year postpartum. These disparities grow with age and extend beyond mortality to include severe maternal morbidity, such as preeclampsia — a pregnancy complication related to high blood pressure — which can have lasting health impacts if untreated including death. Additionally, American Indian, Alaska Native, Black, Native Hawaiian, Pacific Islander, Asian, and Hispanic women all experience higher rates of ICU admission during delivery compared to White women. ICU admission is considered a key marker for maternal complications and system-level failure. Public Health as Partner in Progress Public health has a responsibility to do more than document issues and concerns. We must be in the business of addressing them. In Connecticut, we are working across agencies and community organizations to move from acknowledgment to action. One of the most important leaders in this work is #Day43, an initiative launched by Waterbury Bridge to Success Community Partnership. The name refers to the period between 43 days and one year postpartum, during which approximately 20% of pregnancy-related deaths occur. #Day43 exists to raise awareness of Black maternal health and transform systems to support mothers. Their work spans research, advocacy, policy, technical assistance, and storytelling grounded in lived experience. Waterbury’s maternal health data reflects this crisis. According to the #Day43 Black Maternal Health Report, 18.6% of pregnant women in Waterbury received late or no prenatal care. Those in the city face higher rates of C-sections, limited access to postpartum care, and insufficient support for mental health and breastfeeding. The community described a significant lack of maternity care resources, particularly in the North End, where many Black and Hispanic families reside. Through initiatives like this, residents are not just seen as stakeholders. They are recognized as storytellers, system builders, and agents of change. Their leadership is shaping how we define, measure, and deliver maternal care in Connecticut. This vision aligns with broader maternal health equity efforts across the state. For example, The Connecticut Health Foundation is developing a Maternal Health Equity Blueprint in partnership with community leaders, researchers, and families. Waterbury voices are essential contributors to this process. Listening as a Path of Healing The experiences of Black mothers reflect a broader truth. Too often, our systems are not built to hear them. That lack of trust is both historical and current. It shows up in rushed appointments, dismissed symptoms, and inaccessible services. Community-based providers, such as doulas and midwives of color, are critical to bridging this gap. They do more than provide care — they restore dignity. Yet these providers are often underfunded and undervalued in mainstream health care systems. Public health must champion integrating these providers into existing systems and promoting long-term sustainability. To maximize maternal health outcomes, the next phase of this work must intentionally include structured cross-sector collaboration. It must focus on building systems that educate both providers and families on urgent maternal warning signs, provide consistent discharge education, and strengthen local surveillance and outreach infrastructure. These strategies are essential, scalable, and lifesaving. We cannot improve outcomes without acknowledging the deep cultural, emotional, and psychological work required to rebuild trust. We cannot heal what we do not hear. Re-Examining the “Public” in Public Health Re-examining the public in public health means placing the needs of our most vulnerable communities at the center. It means investing in care that is integrative and supportive with community co-designed solutions. It also means wholistically addressing other intersecting systems that influence maternal outcomes. We can start by: Expanding funding for community-based perinatal health workers, including doulas and midwives. Embedding relevant metrics into maternal health program design and evaluation. Creating statewide listening sessions and family advisory councils to ensure policies reflect lived realities. Partnering across sectors to improve access to safe housing, transportation, and mental health supports for new mothers. Supporting local initiatives like #Day43 that lead from within communities and reflect community-defined solutions. Educating families on health information and individual health rights through accessible, trusted channels. To truly care for and about Black mothers, we must act beyond awareness months and social media campaigns. We must improve current processes and design opportunities that will support them and keep them alive. Public health was created to serve the public. The most powerful way to honor that mission is to focus on the public, ensuring they are a priority and not an afterthought. article 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

DELPH scholars discuss the important role of Community Health Workers (CHWs) in the public health workforce, the need for support, recognition, and investment in their development, and the importance of sustainable funding for CHW programs across the United States.