by Lloyd F. Novick, MD, MPH

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The January/February issue of the Journal of Public Health Management and Practice focuses on State Health Officials (SHOs). Following a lead editorial “SHOing the Way Forward: Mapping a Path for State Public Health CEO Success” by Beitsch, four articles from the SHO-CASE study illustrate the backgrounds, qualifications, tenure, and turnover of these leaders of state governmental public health agencies. Principal Investigator of the SHO-CASE study, Halverson, points out that despite the importance of SHO leadership, there has been a lack of information on factors associated with SHO success, turnover, or competencies. In 2016, the State Health Officials Career Assessment Sustainability Evaluation (SHO-CASE) study was initiated. Both current and former state and territorial officials, serving between 1973 and 2017, were surveyed. Respondents totaled 147 individuals from every state and the District of Columbia. The resulting study database illustrates the characteristics of current and former SHOs and forms the basis for the articles appearing in this issue. This research will be a valuable future resource for those interested in public health workforce issues. Findings from this study are also being used in the design of a new Association of State and Territorial Health Officials (ASTHO) Leadership Institute for training of new SHOs.

Yeager and colleagues provide a detailed examination of the education and background of state health officials. Two-thirds of survey respondents reported having a medical degree, approximately half had a formal public health degree, and almost one-quarter reported a management degree. Approximately two-thirds of SHOs had previous government experience and more than half of these were appointed to their SHO role directly from governmental health experience. These factors all depict a cadre of individuals with education and experience fitting for the job. The proportion of SHOs who were female increased dramatically over time from 5.6% in the 1970s/80s to 46.4% in the 2010s. However, there were no significant changes over time in racial diversity with 16% classified as non-white.

Tenure and turnover of state health officials, a topic of great interest, was studied by Menachemi and colleagues. Average completed tenure among SHOs was 5.3 years and actually shorter in recent decades. Boedigheimer analyzed the perceptions by public health senior deputies of SHO performance. Senior deputies work closely with state health officials making their views valuable. They noted that success factors included an ability to listen, public health experience, and a close relationship with the governor.

This JPHMP issue contains a case study entitled “The National Epidemic of Gun Violence: The Vermont Department of Health Response” which recounts a “near miss” mass shooting at a high school that occurred contemporaneously with the Parkland, Florida, tragedy. The role of the Vermont state health official, Mark Levine, is described as a trusted health promotion and education resource able to frame gun violence in public health and safety terms.

This issue also includes an article by Smock et al examining patterns of catch-up growth and anemia in refugee children younger than five-years of age in the Special Supplemental Nutrition Program for Women, Infants, and Children. As Morrow points out in her accompanying editorial “Fifty Years of WIC: Celebration and Caution,” JPHMP has published numerous articles over the last 25 years, highlighting the WIC program or based on data derived from this intervention.

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Lloyd F. Novick, MD, MPH is Professor Emeritus of the Department of Public Health at the Brody School of Medicine, East Carolina University. Previously, he was chair of this Department. He has served as the Commissioner of Health and Secretary for Human Services of Vermont, Director of Health Services for Arizona, and Director of the Office of Public Health for New York State. Previous academic positions include Professor and Director of the Preventive Medicine Program for SUNY Upstate Medical University, Professor and Chair of Epidemiology at the University of Albany School of Public Health, and Clinical Professor and Director of the Teaching Program in Epidemiology and Public Health at the University of Vermont, College of Medicine. [Full bio]