Transforming Higher Education, Emphasizing Public Health: Spotlight on Dr. Lillian Smith

Posted on April 18, 2025 by Karsen DeWeese

This entry is part 10 of 11 in the series JPHMP Editorial Board Spotlight

This month, the Journal of Public Health Management and Practice spotlights editorial board member Dr. Lillian Upton Smith. Dr. Smith is the Dean of the College of Health and Human Services at Western Michigan University (WMU). She brings her expertise in systems change with a community-focused lens to foster holistic growth and well-being across the entire university. With a background steeped in innovative community engagement and partnerships, she provides leadership that helps transform whatever institution she currently works with, as well as the surrounding community.

Dr. Smith considers herself a pracademic who enjoys fostering an environment where everyone can be innovative and has a deep appreciation for the interdisciplinary work that public health targets. She believes the best work can be achieved through working with both community partners and as a rigorous educational institution, where everyone brings their strengths to the table. One of the things she is most excited about currently is that WMU adopted the Okanagan Charter, which designates the university as health-promoting across all aspects of campus culture.

JPHMP intern Karsen DeWeese had the opportunity to speak with Dr. Smith about her work. Listen to the podcast or read the transcript below.

Transcript

Karsen DeWeese 0:11
I’m so excited to be talking with you today. I would love if you could describe for everybody your path to your current position, what fostered your passion and how your background in both academia as well as working with communities has gotten you to where you are.

Lillian Smith 0:33
Well, thank you so much for the question. So, my work really involves community engagement and workforce development. So it’s very fitting for me, as I’ve always had an applied focus. So for example, when I did my bachelor’s degree, I was a BA in English, Business Communication, so like a tech writer, right? So I was always, kind of moving towards a what can I do with it? Kind of kind of approach. After I got that degree, I actually worked in community organizations and on grants for about 10 years. And then I started realizing that I needed more training to do my job better. I was doing community engagement, community education, outreach, a lot of advocacy. I was a speaker for United Way Speakers Bureau and so, just doing a lot of different things.
And that’s when I actually went back to school and I started my online MPH at Emory.
And it was the first, it was in the first cohort for their online program. And really fortunate, because I was able to be introduced to and work with Doctor Kathy [Kathleen] Miner, who was a huge proponent of practice. So that whole degree was in fact based on the Council of Linkages between academia and public health practice, the core competencies for public health professionals. Now I started that degree in 1999, and those competencies weren’t actually formally adopted until 2001. So I was, we were kind of, we were ahead of the game here, right? And in fact, in 2001, when I started my doctoral degree at USC [University of South Carolina], at the Arnold School of Public Health, I was all about the competencies and what people were doing with competencies and people were just starting to get introduced to them, so that was kind of an interesting time for me. I worked with our Prevention Research Center and I got hired on as a grant writer, and then they loaned me out to the Department of Health and Environmental Control. And I became the lead writer for, for the state, for the CDC-funded cardiovascular health program. We got that funding and that was a five-year program, $650,000 a year. That was kind of a big splash for me, ended up being a great interview, working for the PRC as I was going forward and they did, they hired me and I was working on the community engagement side. And during that time also worked with the Robert Wood Johnson grant for Mobilizing Action through Planning and Partnerships. So that’s when we were developing community needs assessment and improvement planning programming. I started teaching community health assessment for the delivery of healthcare and all the time I’m finishing up my doctorate. My dean at the time, Dr. Donna Richter. She actually was really interested in practice too, and she was on the Practice Council for ASPH, and she would take me with her. And I would sit behind her and our deans, our Associate Deans would be at the table and, and their students would sit behind them, around the wall. And, and she would volunteer me to go and do things like writing for the, “Demonstrating Excellence in Public Health Practice” series. And so I worked on two of those, practice-based research, practice-based service. So as you can see, I’ve always been pretty steeped in pracademia.
This kind of led to me being jointly appointed to DHEC [the South Carolina Department of Health and Environmental Control] and the Arnold School. Each paid half of my salary. I worked on public health training center programs, community transformation grants. And this was all, you know, I think really, I was able to work with colleagues who just kept, and keep thinking, we can do better. And that’s what we did. I mean, we just kept doing better. We kept trying new things, working on new things, and developing new and better programs to serve both our practice communities and our academic communities. And by our academic communities better serving our practice communities, it actually improved our academic communities. It made us stronger.
One of the kind of life changing moments for me came when I was able to work after ACA [the Affordable Care Act] came through, a project called LiveWell Kershaw.
And that’s when we were actually able to start doing community health needs assessments that were tied to nonprofit hospitals. So we actually started having some money to do them, and it also meant that, the nonprofit hospitals had to focus on the priorities that we came up with in our needs assessment. And the LiveWell Kershaw program was born. It’s still operating today. Highly sustainable, successful program for one of the largest rural counties in South Carolina. It has school-based health with telemental health, community, EMS Community Health Workers that we‘re overseeing by Nurse Practitioners, operated through a federally qualified health center, and all this came out of a Community Health Needs Assessment for Kershaw Health System.
So it was really a unique opportunity, but also just a really strong partnership. We were able to bring together a lot of different resources and create a sustainable system. Again, that’s still operating today, that we started that program in 2012.

Lillian Smith 7:10
And honestly, I just started, I was doing a lot of reading at that time about boundary spanners with the Council on Linkages.
We’re always, that’s 22 different disciplines that are working together to really think about, you know, what it is that that we need to be doing for public health professionals. And that really led me to be thinking about not only working in a school of public health, but also, a College of Health and Human services, and that’s where I am today. I’m a Dean of a College of Health and Human Services that has public health and also has occupational therapy, has social work, nursing; has a lot of the different disciplines that are really important, that we all need to be working together through our interdisciplinary education and practice to really be able to serve our communities and serve them well.

Karsen DeWeese 8:05
That’s amazing. I love that so much. It ties in a little bit with what mine [masters degree] has been over. I just defended over how health communication can be an innovative thing and that we need people who are going to bridge that gap that exists right now, because communicators and health professionals are siloed currently.

Lillian Smith 8:26
Mm hmm.

Karsen DeWeese 8:30
And so having somebody who can be a bridge between the two is what I identified in my master’s, so that’s wonderful. That sounds like you also found a lot of ways that we need to bridge practice and research, and I think that’s fantastic. So –

Lillian Smith 8:43
And it’s so incredibly important at the end of the day, we should be teaching what we practice and practice what we’re teaching. And that’s really, when we look at the old Boyer Model of Scholarship, that’s, that’s really the main emphasis. How do we actually take what is our research interest and live it? You know, so how are we practicing and doing, doing what we’re, doing in our service, and in our scholarship, and in our teaching? And the way I like to describe it, for me, they’re so integrated, that they’re, it’s hard to discern where one starts, and one stops. Because what I’m doing is the essence of what I do. It’s who I am.

Karsen DeWeese 9:37

I love that. I think that’s so important and such a good reminder for people, because I feel like sometimes everybody gets a little bit of blinders on with what work they’re doing, and so focused on what they’re doing that everybody forgets that we’re all working towards the same goal. And I think it’s a wonderful thing to hear people talk about that being their passion. And so –

Lillian Smith 10:00
Yes.

Karsen DeWeese 10:03
I think that’s great. I read a bit about you before writing my questions today, and I saw that you have stated that your goal is to make healthy decisions easy choices on and off campus by ensuring that the social environment, policies and systems support that goal. And I completely agree. I think that’s a fantastic statement and goal to have. So how,

Lillian Smith 10:27
Mm hmm.

Karsen DeWeese 10:28
How does your work tie into this? What are you doing to help make sure that that’s happening?

Lillian Smith 10:35
Yeah, so this is incredibly important. I mean, when we think about, you know, we’re out, we’re, we’re health promoting in many different ways, working with health promoting organizations, we’re talking about improving health and wellness in our, in our communities, and we’re, we’re developing all these interventions to go out and do these things and, and then we look around us. And, and on our campus. And we have real issues. We’ve had real issues and, so for example, I started working on a student basic needs, when I was at Boise State. And in looking at that, we heard about, I was working with a community college partner, and there was a big push to do surveys on the real college experience, it’s called the Real College Survey on Student Basic Needs.
And they’d been doing them in community colleges. And were just, had just started doing them in four-year universities, and had some really surprising results. They thought that, that it was that basic needs are going to be so much worse on a community college campus than they would be on a four-year institution campus. And
what they found is that there were issues going on at our big universities as well.
And so we signed up to do it for Boise State. And kind of, I guess I was a Co-PI on that.
I don’t know how, I don’t know what you’d call it. But we used that as really, a way to figure out, again, I do community health assessment and improvement planning. And so we started thinking, OK. Well, let’s do the same thing that we do in our community, let’s do it on campus. So to do that we need data, right? So we, when we signed up for this, now all of a sudden we’re gonna have some really rich data other than the other pieces of data that we have on campus. And what we found was really stunning.
We had high rates of homelessness, as in not just sofa surfing. And then we had housing insecurity, which was really high. And then we also had food insecurity as well.
And what we were doing on campus and unfortunately what we see a lot on campus is that, people love to do food kitchens and food, food pantries and things like that.
Unfortunately, if your students don’t have a place to live, they don’t have a place to take the food. And so it ends up, we can’t food pantry our way out of the situation that we are in. What we did, we, we called everybody together, we’re doing a mobilizing for action through planning and partnerships, kind of whole setup. And by this time I’m also doing a lot of work with collective impact, and so we’ve kind of melded that in as well. And really, we brought financial aid, we brought parking, we brought folks that are doing the shuttles, the transportation, housing. Then we have academic affairs. Then we have student affairs. Then we have all these folks, you know that are, that are players on campus. And we bring everybody together and we start actually saying “So what do we need to be working on?” And so that was really my, my first jump into a cross-campus kind of work, and bringing together Academic Affairs and our Students Affairs, which you’d be surprised, they, they don’t really sometimes go together on college campuses.
And another really key component to this is that our students live in the community around our university. So we were also bringing together the people that were providing services and resources in the community. And bringing them to the table as we’re looking at how to handle this. And it ended up being a really strong collaborative that is now housed in the Blue Sky Institute at Boise State. Continue to kind of, to be looking at that work in thinking about are we helping our students. Make sure that they can, that they’re well advised, and can get to graduation with as few student credit hours as humanly possible? And so, you know, if a degree requires 120 credit hours, then you need to be able to get out in 120 credit hours. And not be there for another semester or two semesters. And this really started having me look at different ways that we could streamline our academic programming, work with our community colleges, work with our employers and businesses, because our employers and businesses actually have tuition benefits. So if we can develop programming that is for them. So for example, we were working with St. Alphonsus in Boise, ID, and we developed a, they wanted a, a lower division certificate, so to speak. Just a series of five different classes that, if taken in those first two years, would make our student a preferred applicant when they went to apply for a job at the hospital. And then if they’re just working 50% of the time, then they can have tuition benefit from the hospital. So again, you know, really working on focusing on the student, focusing on things that are going to make their stress down, that are going to make sure that they can get to graduation, to make sure that they’re gaining experiences that are going to help them progress in life and career.
And all the time we’re helping our community business partners, because I promise you, hospitals want people that are ready to work there, and also that they can work with through first job, second job, third job. If they can get them in, and keep them, that’s a huge cost-savings for the hospital system. So all of this work again, just helping to do a lot of different things like that really helps support our on-campus piece as well as our off-campus piece. Another thing that I just want to also share, people that have worked with me in my departments and faculty at Boise State, at Northern Arizona University, now at, at Western Michigan, and honestly, also back at USC, know that I have a very strong feeling that really good and strong infrastructure releases innovation. So when we are in a college, and we are constantly going around trying to figure out how do I put in my travel? How do I get compensated for that? How do I do this? What do I do? Are constantly being frustrated about the way that the systems are working on our campus, right? Then where is your time and energy and your extra, to innovate? And to be excellent in what you’re doing. And so, for me, a big part of making sure that healthy decisions, easy choices on and off campus, is making sure that again, these policies support that role. You want to be at work, you want to be walking. Do we have policies as well that might support us being able to take an hour for our professional staff to be able to go and walk? So what are we doing with all of those things?

Karsen DeWeese 17:11
Well, as someone who has been in academia for a bit now, I think that’s incredible.
I wish that my school had some of those opportunities because those are just awesome and that’s for undergraduates. I would imagine that graduate students also are like, wow, this is fantastic. I want to say thank you for your students, if you never heard it from them, because, man, if they don’t know how lucky they have it, I can say it for them. So, I think that’s wonderful. You already kind of touched on this on how your work is uniting the academia and the communities that you’ve been involved with, but is there anything else that happens that you didn’t get a touch on, answering that last question?

Lillian Smith 17:57
Well, I’ll tell you one of the things. So when, when people say how do you do this? It really is a process. It’s process, process and more process, and building. So making sure that we just continue to work on what we’re working on. So when I say that, I’ll be asked, you know, what’s your leadership style? And I’ll say, well, you know, I am a transformative collaborative leader. And with that, what I mean is the transformation is within the systems themselves. We have to be transformative. We have to work on the things that continuously keep us from hitting our goals. So if we know we have processes, we know we have systems that don’t work for us anymore, and we just keep complaining about them, then they will continue to always keep us from reaching our goals. So we have to work on those things. We call them contradictions.
So they tell us to go, in higher ed. [education], they always say, well go and do interdisciplinary work. Yet we, we don’t have incentives in our tenure and promotion criteria that actually would incentivize and, and/or reward us for doing that. So we have to change that. We have to actually incentivize what we feel is important, and we have to measure what we think is important. And so for me, we have to use a really, slightly different strategic planning process, and it’s through the Institute of Cultural Affairs, and is called Technology of Participation.
And it has just a really neat set that allows us to do an environmental scan, jump in there, where we want to go, to have a practical vision element, so goals. To think about those underlying contradictions and then to say, OK, so based on these underlying contradictions. How, you know, how do we take care of these so that we can meet these goals that we want to meet? That then drives us to what we call our strategic directions. And from there, we set up plans for three, six, nine months, and we are constantly working, updating, staying in good communication and able to actually make change happen. And when we’re able to do that and we’re co-creating our future together, then people get on board. Not everybody’s gonna get on board. You’re always gonna have a curmudgeon who’s gonna say ”that’s never gonna work.” And great, we need you there. We still need your voice. And then we’re gonna have people that begin to see that, wow, we actually can achieve goals by working together. Unless we get a little success under, under our belt, then it really works. And I think one of the things that’s really important when we talk about our community, and academic partnerships and collaborations is, you know, for me, I work in a regional comprehensive university.
And a regional comprehensive university has a responsibility, it is accountable to the region. We have a responsibility to really be more outward looking. And I take that very seriously. And one of the things I think though, that the people don’t really understand is that, it also helps us do the work that we’re supposed to be doing if you were just to look at ourselves as being academics in a college, right? Because if we’re out in the community and we are making a difference, a real difference in people’s lives, and we’re there in an authentic way, really doing help. Then our community members and community people and organizations, and businesses are gonna think about us as a positive contributor to the community. And that’s pretty big right now, when we have so many people across the United States, have more of a negative look at higher ed. So how do we actually change that? We change it by being and doing the things that are actually gonna end positively impact our community. And so it helps us with recruitment, retention. It helps us with promotion, marketing, doing all of those things.
So again, it really helps me do my job to be firmly embedded in my community.

Karsen DeWeese 22:40

Absolutely. Thank you so much for talking about your process and how you do all these things. I want to be mindful of your time. So, I’m gonna skip ahead a little bit to, because I know that the journal would love to hear your response on this. So, with all of your work, you’re obviously incredibly busy. You’re doing amazing things, every bit of your time, so how does being an editorial board member for this journal enhance your knowledge or passion in what you do?

Lillian Smith 23:11
So incredibly important to keep your thumb on what’s going on across our nation. And so the people that are contributing to the journal, that are submitting manuscripts, that are writing and are doing for governmental public health, public health in general, all the things; they’re applying new knowledge. They are constructing new knowledge with their research, with their scholarship, and so being able to have a front row view to that, helps me stay on top of all of the important changes that are occurring. It helps me to see what the best practices are. That I can take and integrate into my work here. It helps me to actually refer and to nudge my faculty to say maybe you want to look at this.
This is up and coming. I think another thing that’s really important too, is just the camaraderie and the information that is shared through the editorial board itself. My colleagues on the board have incredible histories and are doing just really important work and from many different settings, and that’s important to me, in that I just learn so much, all the time. It helps me to stay as a learner as well.

Karsen DeWeese 24:47
That’s so wonderful. I know that we’re right at time pretty much, but is there anything extra that you want to highlight or talk about that we didn’t get the chance to get to?

Lillian Smith 24:58
I do have one more thing, just briefly. And that is, when we talk about on campus. One of the things I was excited about coming to Western Michigan University is they have signed on to the Okanagan Charter. And it’s an International Charter for Health Promoting Colleges and Universities. So when we talk about the on and off campus communities, this is geared directly for how colleges and universities can promote health and well-being on their campus. We were an early adopter, we were one of the first 22 universities to actually do this, but this gives us a framework to really work within. And you know, in public health we always love a good framework. So I really wanna encourage my academic colleagues across the US to look into the Okanagan Charter and think about how as colleges and schools, schools of public health, but colleges of health and wellness and whatever we’re doing, how should we be involved in leading and/or contributing to these initiatives on our campuses?

Karsen DeWeese 29:39
I think that’s wonderful. Thank you so much for your time today.
I want to be mindful, but thank you so much for being willing to be a part of this.

Thank you again, Dr. Smith!

About the Author

Karsen DeWeese: Karsen DeWeese is an intern for the Journal of Public Health Management and Practice. She is finishing her Master of Public Health degree at Kansas State University and will be graduating May 2025, with an emphasis area of physical activity and a graduate certificate in strategic health communication.

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