Student forum

All students of Public Health are invited to contribute comments or opinions to this forum regardless of academic status or setting.  Please limit them to two double spaced pages using a 12 point font and send them to for consideration subject to appropriateness and editorial review.

The Kind of Leaders Needed in the Valley to Improve the Health of the Population

                                       Opinion-Chivariak Khus- 25 November 2018

    All public health practitioners know that change for an individual is not easy and that changing an entire population is even harder. Today, the Rio Grande Valley is one of the most impoverished areas in the United States with high rates of uninsured combined with generational poverty. Transforming the Rio Grande Valley’s public health infrastructure and outcomes will require patience, coordination, creativity, and a great deal of determination. Change can start to happen with a new type of leader equipped with the necessary qualities and skills to make lasting changes. 

     First, the right leader has to exhibit the highest levels of integrity. Integrity is important because it will nurture trust with other leaders and relevant stakeholders, as well to help provide a reliable moral compass that will help successfully navigate the different and often conflicting interests and personalities. Without the required integrity, the existing culture, social and economic realities will become more likely to force compliance and conforming to the current systems as opposed to transforming into something better. 

     Second, the leader has to have a clear and ambitious vision of the desired changes, where everyone will benefit from those changes. The ideal vision needs clarity and should reflect the concerns, aspirations, and realities of all those involved. A wise leader will start by first listening to different opinions, thoughts, fears, and goals of key stakeholders and to then build a shared vision to unite the opposing interests.    

     Third, the right leader needs to demonstrate an emotionally intelligent charisma. Part of the dynamics of change is recognizing individual needs and concerns and working with all to find mutually acceptable solutions. All cultures and systems are maintained by people, who are subject to influence under certain conditions. Charisma in this public health context means inspiring and motivating influential decision-makers to align powerful private interests with that of public health. Attaining both public health benefits and advancing individual interests positively and constructively is challenging, especially when politics is polarizing. However, the very essence of the necessary leader is to convince the doubters of the power of collective synergy, that collaboration can accomplish much more than a divided community. Inspiring and motivating should not come from fear, but instead look to leverage positive opportunities to make sustainable changes in health outcomes for all people of the Rio Grande. Practicing emotional intelligence strategies will help the leader to build the required trust and relationships. 

     Fourth, the Rio Grande needs leaders who are selfless and vigilantly advocating for a greater common vision. The right leader listens, seeks to understand, and acts on other peoples’ interests for the benefit of society. This leader must demonstrate subcomponents of selflessness including humility, sincerity, sacrifice, and competence along with a good sense of humor. Finally, participatory leadership style is vital for thriving in a world that is more complex with better-educated and diverse people. Participation means sharing power and work responsibilities, which in turns addresses one of life’s more significant challenges, sustainability of effort. Increasingly, machines will replace simple tasks, while humans will continue to focus on creative and nuanced work that requires subjective interpretation and skills.

                    What kind of leaders are needed in the Valley to improve  

                                         the health of the population?

                           Opinion – Yetunde Kare-Opaneye – 25 November 2018

   In 2009, the US Census Bureau reported that 50.7 million Americans (16.7% of the population) did not have health insurance. People without health insurance are less likely to receive recommended preventive services and screening and as such have poorer health outcomes for chronic illnesses like diabetes, cardiovascular disease and cancer. Like many underserved communities in the United States, the residents of the Rio Grande Valley (many of whom are Hispanic Americans) lack access and are saddled with social issues that affect their health like transportation difficulties, limited health literacy, lack of fluency in English, low income level and low education level.

   Due to the peculiarities of their health issues, its outcomes and the many social factors that affect health in the Valley, there is an emergent need for effective leaders, leaders with the desire to make a difference, leaders that are passionate about the community, and those that are willing to serve and advocate for the people, most of whom are immigrants, medically underserved and living below the poverty level.

   Tackling the health issues and improving health in the valley is expectedly daunting due to the prevalence of chronic illness like obesity, diabetes and heart diseases. Many of these illnesses require lifestyle modifications, a shift in the people’s belief system and ideas that negatively impact health to those that influence health positively. For instance, a shift from consumption of fatty, unhealthy foods to healthy eating, with a diet rich in vegetables and fruits; change from physical inactivity to an active lifestyle. 

   A leader that will make the most effective impact on the health of the people in the valley, in my view, should be a key member of the community, someone that truly understands the unique problems of the area, able to identify the root causes of these health issues, the resources available to the community and who is equipped to effectively address these issues. Such a leader will have to possess certain attributes that are paramount to effective leadership. The leader will need to be knowledgeable, experienced, committed, patient and with the ability to negotiate and work with others to achieve set goals. The leader has to be inspiring, motivating, creative, courageous and passionate. The leader will need to utilize a leadership style that not only fits his or her personality but encourages community engagement and participation, and importantly “buy in” from stakeholders. For a community like the Valley, a democratic leadership style will allow for inputs from community members and stakeholders and may be best suited. Other skills needed by a leader in the Valley will include ability to communicate evidence-based health related information in a format that is easily comprehensible. Since the majority of the residents of the Valley is Spanish speaking, bilingual education tools should be employed for better understanding. 

   Another very important aspect of leading and impacting the health of the people of the Valley is having a culturally competent leader, a leader that is sensitive to the cultural values of the people as it relates to their health and is able to bring about the much needed changes in ways that promote the health of the people without being judgmental. 

   As a summary, in order to improve the health of the people of the Valley, there is a need for appointment of leaders who are passionate and capable of driving policies that put the needs of the people foremost. 

Public Health Leaders Must Meet Valley Growth with Unification of Efforts for

                                                      Increased Access

                                          Opinion-Maria T. Roque-25 November

   As public health leaders, it is our job to increase awareness of our mission. Most locals might readily identify public health with efforts such as PSAs on Zika transmission or diabetes screening programs. These are only some of the valuable services offered by our field. We focus on prevention and addressing the root causes of health problems, which can include poverty, education, and language barriers. 

   Public health emphasizes a community-wide approach to improve health status. Modern shifts within public health have made it easier to include the community in our interventions. For example, The Patient Protection and Affordable Care Act (ACA) has expanded the role of public health practitioners in the current health system by increasing community needs assessments (Yphandities, Escoboza, & Macchione, 2015). I believe the Rio Grande Valley is the perfect place to enact this participatory model, in which the community is included in determining their health needs. The Rio Grande Valley, although geographically expansive, is tightly-knit; I have not witnessed unity like this anywhere else in Texas. Its people value education and hard work, and these assets can be mobilized to improve health outcomes. 

     Expanding community capacity by unifying efforts

   For all its promise and growth, the Rio Grande Valley is facing equally salient health problems. For instance, the Centers for Disease Control and Prevention (CDC) Programs to Reduce Obesity have identified Hidalgo County as a High Obesity area. Hidalgo County’s adult obesity prevalence is 42.9%; the state’s overall adult obesity prevalence stands at 29.2%. 

   Public and private funds are available to tackle this and other health issues, but the know-how for identifying these funds and writing grants to apply to these programs is lacking. Public health leaders must empower and educate others to seek these opportunities. One suggestion is cross-training community leaders in these grant-writing skills through community workshops. Participation and leadership are critical factors in operationalizing community capacity; a community lacks capacity when its public health leadership does not actively involve residents.

   To gain community trust, we must cultivate relationships within community networks. There are many programs in the Valley working to improve people’s lives. Some focus on children and food access; others focus on faith and education. I posit that these are all public health efforts, and a coalition of public services would strengthen these efforts. By sharing information and resources, we will not only foster community networks but be better prepared to identify and tackle health problems. It is up to public health leaders to weave these efforts together and lend an interdisciplinary perspective when building capacity to promote wellness in the Rio Grande Valley.