At a meeting of local public health administrators, it was evident who had been through the year-long Mid-America Regional Public Health Leadership Institute program and who had not, a meeting observer later told institute director Louis Rowitz.

"Those who hadn’t gone through the institute kept saying, ‘I, I, I’ and those who had kept saying, ‘we, we, we’," Rowitz says. "The latter says someone is not only committed to public health, but also knows it’s a team-based profession. Individuals need to develop themselves, but they also need to learn how to act within a team, agency, professional, and community context."

In the past seven years, 270 professionals identified as leaders in public health have "graduated" from the institute with what Rowitz trusts is a broader perspective of and a renewed appreciation for what can be accomplished through the application of such concepts as the core functions of public health. Institute fellows have been administrators from state, county, and local health departments across Illinois, but they also have included local board of health members, directors of community-based agencies, and influential state legislators.

The impetus for creation of the institute came from two national reports, The Future of Public Health by the Institute of Medicine and the U.S. Department of Health and Human Services’ Healthy People 2000, containing national health promotion and disease prevention objectives for the millenium. The IOM report contended that the public health delivery system in the United States was, by the late 1980s, in "disarray" and rendered increasingly ineffective by its insular structure. The report stressed that "greater emphasis in public health curricula should be placed on managerial and leadership skills."

The pioneering Illinois institute has served as a model for state-based public health leadership training centers across the United States, with six other states or regions having used its structure and methods to guide their own initiatives. In recent years, as the reputation and reach of the institute have grown, participants have included public health practitioners from Indiana and Wisconsin. North Dakota is also considering sending a team of public health leaders to the institute for training next year.

The leadership development program has goals on two levels: 1) helping participants hone their personal leadership skills; and 2) helping those already in public health leadership positions improve organizational effectiveness in carrying out the public health core functions of assessment, policy development, and assurance. At the end of the year, participants should have achieved a thorough understanding of the characteristics of effective public health leadership and practical tools they can utilize to reach goals within their spheres of influence.

Each year, the training is anchored by three key meetings: three and a half days at the start as a kick-off and orientation; three days mid-year that give participants the chance to present case reports; and three days at the end of the year that provide a culmination, including team technical assistance projects and individual agency/mentor projects, plus additional information through featured speakers who are national leaders in public health.

The institute experience provides participants the opportunity to learn leadership theory and techniques in a collegial environment and to apply them in the kinds of real-world situations they encounter in working life. The fellows’ first assignment, for example, is a team-based case study developed around a public health issue. The teams are guided by mentors, most of whom have been through the program themselves.

In addition to case studies, other assignments include technical assistance projects, agency-based projects, readings, speakers, and multimedia presentations. All are employed with a view to emphasizing the objectives of the program. Additionally, faculty and staff of the institute have developed leadership journals, a resource center and clearinghouse, a manual for mentor development, a "train-the-trainer" program, annual alumni update workshops, contract courses, a leadership seminar series, and a board of health member training approach called "Operation Partnership."

Dave Carpenter, director of the Illinois State Laboratories, and Georgeen Polyak, director of the near suburban Oak Park Health Department, are two institute graduates and recent mentors who affirm that the program is rejuvenating and enlightening.

"I came away from it with essentially two significant observations," Carpenter says. "One, because of the way the institute is managed and the fellows are selected, the program guarantees that parts of public health in Illinois that may not have communicated very well before do communicate well with one another now. It gets people together in an environment of ‘walk a mile in my shoes.’"

"Second is the organization of management, the devices they use such as encouraging the heart and sharing the vision," Carpenter adds. "When you get a group of people together and they go through this training in an orderly way with academic professionals who make them explore themselves, they see how they might improve. It made me realize again why I do what I do, why I’m in public health."

Polyak says that the networking the program fosters is important. "Most people working in public health today were not trained in public health. So, this is really a fundamental kind of experience for participants. It makes public health cohesive for people who come from social work, nursing, biology, you name it."

At the six-month meeting last April, one 1998–99 fellow unknowingly provided the best testimonial Judy Munson, associate director of the institute, has heard. Earlier the fellow had complained about the program. Now she had achieved a new vision of public health. "As she was walking past talking to another participant, she said this had been the most remarkable experience she had ever had," Munson recalls. "She said she had had no idea public health has so many stories to tell because, before, she had always seen it from the standpoint of her own little specialty."

Contributed by Rick Asa