By the time Ed Baker was appointed as Director of the Public Health Practice Program Office (PHPPO) at the Centers for Disease Control and Prevention (CDC) in 1990, he had already accomplished much in public health: trained in epidemiology in CDC’s Epidemic Intelligence Service (EIS), post-MD degrees in epidemiology and occupational health at the Harvard School of Public Health where he also had a faculty appointment, then National Institute for Occupational Safety (NIOSH) Deputy Director, leading a range of initiatives designed to prevent occupational disease and injury. But in taking the helm at PHPPO in the wake of the 1988 publication of the Institute of Medicine’s (IOM; now National Academy of Medicine) report on the Future of Public Health, Ed’s work at the CDC became watershed events for public health practice for the next two-plus decades.

To both respond to the IOM report and to better position public health practice during the first term of the Clinton administration when the focus was on healthcare reform, Ed co-chaired (with Jim Harrell from the Office of Disease Prevention and Health Promotion/HEW) the Core Public Health Functions Steering Committee that subsequently operationalized what the IOM had defined as the three core functions of public health: assessment, policy development, and assurance. The result of the committee’s work was the establishment of the Ten Essential Public Health Services (10EPHS), the fundamental activities led by governmental public health agencies that should be available to all communities. The 10EPHS in turn became the framework for the CDC’s National Public Health Performance Standards, which helped to serve as further impetus to develop what has become the national voluntary accreditation program for public health agencies through the Public Health Accreditation Board (PHAB). The standards and measures used by PHAB are based on 10EPHS. Thus, there is a clear path that Ed led in blazing from the 1988 IOM report to a national accreditation program that currently assures the provision of the core functions and 10EPHS for approximately 90% of the US population.

One of us (P. Halverson) had the good fortune to serve as a member of Ed’s leadership team at PHPPO/CDC. Ed was a major force for change at CDC and a tireless advocate for public health practice. His work in promoting systems change and public health infrastructure led to transformational impact including the creation of the Health Alert Network, the Secretary’s Report on Public Health Infrastructure, and the inclusion of a regular chapter on Public Health Infrastructure in the HHS Healthy People Goals for the Nation every ten years. The Health Alert Network served multiple purposes in communication but also became foundational to infrastructure building for state and local health departments that would also manifest in the public health preparedness grants and the current Public Health Infrastructure Grant (PHIG) program. Ed was also a champion for building a strong national public health infrastructure through his support of national associations that support public health organizations, including the Association of State and Territorial Health Officials (ASTHO), the National Association of County and City Health Officials (NACCHO), the American Public Health Association (APHA), the National Association of Local Boards of Health (NALBOH), the National Network of Public Health Institutes (NNPHI), and countless collaborative meetings that brought people together. One of the outcomes of such collaborations was the development of a national agenda for Public Health Services and Systems Research. At PHPPO/CDC, Ed was an indefatigable coach and mentor who invested in his staff and saw their success as his personal responsibility and point of pride.

Leadership for the public health workforce has been a major focus of Ed’s work over the past 30 years. While at PHPPO and later at the North Carolina Institute for Public Health, Ed had a major role to play in the success of the National Public Health Leadership Institute (NPHLI). Established by CDC in 1991, NPHLI offered a unique opportunity for public health leaders at the local, state, and national levels to engage in a year-long, cohort model of leadership development focused on systems thinking, communications, and team development. The NPHLI spurred the development of state and regional leadership institutes that greatly expanded the reach for leadership development across the nation. A 2005 evaluation of the NPHLI showed that the leadership training increased collaborative leadership and built knowledge-sharing and problem-solving networks.¹ In ways that go beyond measure, and, we think, reflect the true value of this leadership development for Ed, are the career-long personal networks that flourished as a result of being in a particular cohort. Those networks always led back to, and most often included, Ed.

For more than a decade, one of us (S. Helm-Murtagh) has had the privilege of co-teaching leadership to doctoral students in global public health with Ed, and in that time, has watched him do something rare: he didn’t just teach leadership—he quietly formed leaders. Drawing on a career that spans service as Assistant Surgeon General, leadership at PHPPO/CDC, and stewardship of some of the field’s most important training and leadership infrastructures, Ed brings history, practice, and principle into the classroom in a way that feels both grounded and urgent. But what students remember most is not the résumé—it is the way he challenges them to aim higher, think more clearly, and lead with purpose.

As one student put it, “Ed truly brought out the best in us to aspire to be the very best public health leaders we can be.” Another reflected that his “timely examples with such a positive approach” were “truly uplifting,” and a third captured what many discover only in hindsight: “He made it an incredibly transformational course.”

That blend of wisdom, generosity, and moral seriousness is Ed’s signature—and it is why generations of students leave his classroom not just better informed but changed.

In 2004, Ed and his UNC colleague Dr. Janet Porter made a proposal to Dr. Lloyd Novick, founding editor of the Journal of Public Health Management and Practice (JPHMP), to write something on day-to-day management for the public health practitioner. Thus began (with this first entry) what has been a 22+ year feature of JPHMP, “The Management Moment.” While we cannot count the number of these columns that were authored by Ed (either alone or with other colleagues), managing editor of JPHMP Sheryl Monks notes “it would appear that approximately 130 columns in the series have been published since 2004.” For the 25^th anniversary issue of JPHMP, Ed summarized what he considered to be the most important take-home messages from The Management Moment.² At the top of the list is using these “brief evidence-based suggestions” for improving organizational effectiveness, while at the same time recognizing that for many leadership challenges in public health agencies – managing the boss, succession planning, and transitioning to a new position, to name a few – the paucity of evidence from the literature offered opportunities to create new evidence through the conversations that have unfolded in and because of the column. Creating evidence for value of the path even as he is blazing it. Quintessential Ed Baker.

Finally, one of Ed’s gifts that comes from a deep well of mindfulness, humility, and care is raising other people up in whatever he is doing. In surreptitiously preparing this tribute, Ed told one of us, “When I presented the concept [of the 10EPHS] to [then CDC Director] David Satcher, he asked that the word “Essential” be added, which we did of course.” The Management Moment proposal that he and Janet Porter presented to Lloyd Novick, was an idea “for which Dr. Janet Porter deserves full credit.”^2(p.90) And for the leadership class at UNC: “Susan (Helm-Murtagh) is the real brains behind the leadership course at UNC; I just do what she tells me.” So many of us have been the beneficiaries of his grace, which, to borrow a line from Wendell Berry’s description of Norman McLean’s A River Runs Through It, “is modest, solitary, (and) somewhat secretive — used, like fishing, to catch what cannot be seen.” 

References:

1. Umble K, Steffen D, Porter J, et al. The National Public Health Leadership Institute: evaluation of a team-based approach to developing collaborative public health leaders. Am J Public Health. 2005;95(4):641-644.
2. Baker EL. Reflections on Public Health Leadership. Journal of Public Health Management and Practice. 2019;25(1):90-91.

About the Authors

Paul Erwin, MD, DrPH, CPH, is Dean of the School of Public Health, University of Alabama at Birmingham. He is board certified in internal medicine and public health and preventive medicine, a Fellow of the American College of Preventive Medicine, and an associate editor of the American Journal of Public Health.

Susan Helm-Murtagh, DrPh, MM, is an associate professor in Health Policy and Management at UNC Gillings School of Global Public Health, teaching strategic management, leadership, and health policy in the DrPH and Executive MHA programs. She previously served as a vice president at Blue Cross Blue Shield of North Carolina and is past board chair of the National Interscholastic Cycling Association and the Davis Phinney Foundation for Parkinson’s.

Recommended:

• The Leadership Library, a repository of Dr. Baker’s column “The Management Moment”