Public health has spent the last several years talking about workforce shortages. And for good reasons, health departments and public health organizations across the country are facing vacancies, retirements, burnout, limited pipelines, and increased demand on staff who are already stretched thin. These challenges are real. They affect what public health agencies can do, how quickly they can respond, and how well they can sustain their work over time.
But there is another shortage we do not talk about enough. Public health is not only experiencing a workforce shortage. It is also experiencing a systems implementation shortage.
In other words, the problem is not always that public health professionals do not know what needs to be done. Often, they do. They understand the data. They recognize the needs. They know the evidence. They can identify the priorities.
The harder question is whether organizations have the systems, structures, leadership alignment, and operational capacity to actually move from knowing to doing. That is where the experience and training of the Doctor of Public Health, or DrPH, becomes especially important.
The DrPH is not simply a degree for people who want to know more about public health. It is a practice-based doctoral degree designed for people who want to lead, implement, and build. At its best, DrPH training prepares professionals to work in the space between evidence and action. That space is where much of public health actually happens.
It happens when a health department completes a community health assessment and then has to turn findings into a realistic community health improvement plan. It happens when workforce development is identified as a priority, but the organization needs a structure for training, succession planning, competency development, and staff engagement. It happens when emergency preparedness cannot sit in a separate silo, but must be connected to communications, leadership, operations, and the broader workforce. It happens when quality improvement is not just a project, but a way of strengthening how an organization functions. These are not just technical tasks. They are implementation challenges. And implementation is where many public health systems struggle. Public health is often carried out through a wide range of programs, policies, and partnerships that may not appear connected at first glance. Part of the DrPH leadership role is helping weave a through line across those efforts so staff, partners, and stakeholders can see the shared mission behind the work.
This is not because public health professionals lack commitment or expertise. The field is filled with deeply committed people who understand their communities and care about the work. But even the strongest individuals can struggle in systems that are fragmented, under-resourced, reactive, or unclear about priorities. A competent workforce matters. But individual competency does not automatically create organizational capacity.
That distinction is important. Competency is what a person knows or is able to do. Capacity is what a system is able to sustain.
A health department may have skilled staff and still lack clear internal communication. It may have strong programs and still struggle to coordinate across divisions. It may have data and still lacks a process for using that data to guide decisions. It may have plans on paper that are not fully connected to staffing, resources, timelines, or accountability. This is where DrPH leaders often make their greatest contribution. They help build the conditions under which public health systems can function effectively.
That may sound less visible than leading a major initiative or launching a new program, but it is often the work that determines whether those efforts succeed. Systems-building includes aligning priorities, strengthening processes, supporting workforce development, connecting partners, applying evidence in practice, and helping organizations move from isolated activities to coordinated action.
It is the work of asking: What needs to be in place for this to actually happen? That question is central to public health leadership. It is also central to DrPH training.
DrPH professionals are often prepared to think across multiple levels at once. They understand the importance of evidence, but they also understand that evidence does not implement itself. They are trained to consider leadership, policy, workforce, organizational culture, resources, community voice, and political realities. They know that the best public health strategy is only as strong as the system responsible for carrying it out.
This is especially important now as the field continues to rebuild and provides us with opportunity to broaden the conversation. Yes, public health needs more workers. But we also need stronger systems to support those workers. We need organizations that can absorb change, respond to crises, sustain improvement, and translate community priorities into meaningful action.
That requires leadership focused not only on programs, but on the infrastructure that allows programs to work. It requires leaders who can help organizations move from plans, priorities, and evidence to coordinated, sustainable action. That is one of the most valuable roles DrPH professionals can play.
This is the less visible, but essential, work of DrPH leadership: helping public health systems move from intention to implementation.
In many ways, the future of public health leadership depends on this kind of capacity-building work. Not because DrPH professionals have all the answers, but because the degree is grounded in the idea that knowledge must be applied, adapted, and sustained in real-world settings.
This work also requires a renewed commitment to collaboration across disciplines. Public health leaders are trained to work across medicine, science, business, policy, law, education, and community systems; however, those fields must also make space for public health perspectives in decisions that affect population health, well-being, and the conditions in which people live. In the current environment, strengthening that shared understanding is not optional. It is essential.
Public health does not improve simply because we know what should happen. It improves when we build the systems that allow it to happen. That is the work ahead. And it is work DrPH leaders are uniquely prepared to do.
Interested in learning more? Please visit us online at http://www.nadrph.org/
About the Author
- Lisa Harrison Gulla, DrPH, MPH, MAE, HO, REHS is a Policy Co-Director of the National Association for Doctors of Public Health (NADrPH) as well as a public health professor, practitioner, and private consultant.
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