Introducing Boots on the Ground:  Narratives from Today’s Local Public Health Workforce

Introducing Boots on the Ground

I have clear memories of my first senior staff meeting as Commissioner of Health for Onondaga County. I was following in the footsteps of a legendary health commissioner and Editor-in-Chief of the Journal of Public Health Management and Practice, Lloyd F. Novick, and I had overwhelming symptoms of “impostor syndrome.” Who was I to think that I could lead a large, well-respected academic health department? How could I possibly do justice to this role? What was I thinking? I started out that first meeting with a reflection on my appreciation for hard work done by each of the bureau directors and by the people with whom they worked. I ended that meeting with a clear ask of each director: to reflect on how we could continue to strengthen our health department. As I spoke, it began to sink in that I could do this job because I was part of a team of dedicated individuals working together with the shared goal of improving the health of the community we served.

In an ever-evolving world of public health, population health, and population health management, it seems that more people from an expanding list of organizations are “owning” community health improvement. While at a fundamental level only governmental health departments have the legal authority to protect the public’s health, for example through food safety (restaurant inspections) and surveillance (communicable disease reporting), many organizations, including those within the health care delivery system, are increasingly meaningfully contributing to preventing illness and promoting wellness. Leaders at local health departments have the choice to embrace this evolution and welcome more collaborators to the table or to step back and relinquish some of their traditional responsibilities to enthusiastic new players.

“Boots on the Ground” is JPHMP Direct’s new series dedicated to local and regional health departments (LHDs). The series will address the practice of public health from the perspective of those working in LHDs and will provide an informal platform for public health leaders across the country to share their stories of how public health is accomplished in real life, in real time. Each narrative will rely on storytelling to paint a picture of the interesting world in which the local public health workforce lives. The series is intended to showcase the work done by LHDs and to celebrate the successes that occur every day within an LHD. Furthermore, ideally, the series will provide lessons learned to advance the practice of public health and to keep LHDs at the center of health improvement efforts in their communities. Both clinical public health programs and non-clinical public health programs will be represented. For example, one month the column may address how an LHD is tackling an increase in gonorrhea in its community while another month the column may address how an LDH is addressing the opioid crisis. In addition, the column will serve as a forum for public health practitioners to share stories of management, such as how a quality improvement initiative resulted in operational changes within the LHD.

As with community health improvement, we are stronger if we work together. If you are interested in sharing your story, please contact Dr. Cynthia Morrow at

Author Profile

Cynthia Morrow
Dr. Cynthia Morrow is the health district director for the Roanoke City and Alleghany Health Districts in Virginia and the co-Domain leader for Health Systems Science at the Virginia Tech Carilion School of Medicine. Previously, she was the Commissioner of Health for Onondaga County, NY and the Lerner Chair for Health Promotion at Syracuse University. Her prior academic positions include Professor of Practice in the Department of Public Administration and International Affairs at Syracuse University and an assistant professor with the Center for Bioethics and Humanities as well as with the Department of Public Health and Preventive Medicine at Upstate Medical University. She is a consulting editor for the Journal of Public Health Management and Practice and is also a co-editor/co-author of five books, including Essentials of Public Health, Fourth Edition (2020); Public Health: What it is and How it Works,7th Edition (2020); Bioethics, Public Health, and the Social Sciences for the Medical Professions (2019); JPHMP’s 21 Public Health Case Studies on Policy & Administration (2018); and Public Health Administration: Principles for Population-Based Management (2008). She is a graduate of Swarthmore College (BA) and Tufts University School of Medicine (MD, MPH).