Letter to Senate Committee

Over the 35 years that I’ve worked on public health workforce development, I’ve heard comments from policymakers about how — from their standpoint — different public health organizations advocate for many different and seemingly competing interests and priorities. Because public health leaders use multiple ways to say essentially the same things, to a policy maker it often sounds like we are competing with one another and sending different messages. As a result, policy makers often dismiss our ideas and neglect the public health community’s legitimate needs.

Earlier this year, we saw a timely and urgent opportunity to speak with one voice when the National Consortium for Public Health Workforce Development Steering Committee learned that the Senate Committee on Health, Education, Labor and Pensions was seeking input regarding strategies to improve public health workforce training and encourage innovation to address workforce needs. Together, we made the decision to send a joint letter to articulate our vision for investment in the public health workforce.

At the outset, the intention was to send the letter on behalf of the National Consortium. We had been working collectively to develop the Consortium’s Common Agenda, so our ideas regarding workforce development were essentially already established and agreed upon. Those ideas formed the basis of the letter.

We shared our vision for strengthening and meeting the needs of the public health workforce and strategies the federal government can implement to help achieve this vision. We recommended that the federal government consult state, Tribal, local, and territorial health departments to inform decisions being made at the federal level; guarantee predictable, sustainable, and long-term funding; ensure sufficient staffing; support the development of a diverse workforce better able to achieve health equity; and ensure the resources needed to reach, screen, and hire diverse candidates with the skills needed in public health today.

While we were able to capitalize on the opportunity to share our ideas with the Senate Committee, we learned, or affirmed, two lessons in the process: 1) the need to recognize the constraints, priorities, and processes of the participating organizations in advance and, 2) that speaking with one voice is more important than speaking as one entity.

Recognizing Constraints, Priorities, and Processes

There was a short timeline to get the letter to the Senate Committee, and several organizations within the Consortium have internal processes they must undertake to sign on to this kind of letter. Some members of the Consortium are member organizations themselves and needed approval from either their members or their board of directors. There were also organizations that perceived the letter as a lobbying activity, which they prohibited from because of their status as a nonprofit organization or as governmental agency. Others needed to coordinate this type of activity with their government affairs offices to ensure alignment with the organization’s policy priorities. These are valid issues and important to consider — in advance — for the future.

Speaking with One Voice is the Priority

Once everyone who could sign on to the letter was ready, it became clear that it was not appropriate to sign as the Consortium without all members being signatories. Therefore, those of us who did sign the letter — including the Public Health Foundation — did not identify ourselves as being members of the National Consortium for Public Health Workforce Development. Instead, we introduced ourselves as a group of leading public health organizations with similar values and goals who came together to communicate our ideas in a collective way.

It is not necessary to speak as one entity to speak with one voice. We can communicate on behalf of our organizations, and in a manner that sends a consistent message to policymakers. Sending consistent messages is one way to reinforce and amplify strategies. When many public health organizations send inconsistent and mixed messages, we can confuse policymakers. The result is that our collective public health agenda is sidetracked and does not move forward. The consensus development model we have been using for over 20 years with the Council on Linkages Between Academia and Public Health Practice (Council) is to speak with a consistent, not single, voice about priorities across the diverse public health organizations represented on the Council. This has resulted in changes to accreditation standards for academic programs, adoption and regular updating of the Core Competencies for Public Health Professionals, collaborative efforts to foster and expand academic health departments, and many other important and successful initiatives.

At the end of the day, each of our organizations can go their separate ways and send mixed and inconsistent messages. This has never served our community well or the communities we serve. The preferable choice, and one made more feasible with the National Consortium for Public Health Workforce Development, is to develop consensus and speak with one consistent voice, achieving a better future for today’s and tomorrow’s public health workforce.