An ecological perspective of public health leadership

An ecological perspective of public health leadership

Introduction: Leadership in a public health (PH) setting is a challenging, highly visible activity that requires individuals to innovate ideas, to execute agency objectives, to motivate and guide personnel, to plan and allocate agency resources, to sense and respond to changes in an agency's environment, and to relate their actions to the general population. When done well, population morbidity and mortality decrease. There has been little attention in PH to systematically define factors that influence the development of strong leadership.

Methods: Six leadership theories (Behavioral/Trait Theory, Contingency Theory, Path-Goal Theory, Leader-Style Theory, Hersey and Blanchard Theory, and Transformational Leadership Theory) were reviewed for contextual traits, theoretical underpinnings and limitations. Common themes were categorized into general factors. Each factor was further classified into specific domains.

Results: A framework for understanding leadership development is postulated in which 14 factors (e.g., economic, historical, and political conditions; human rights policies; population ideologies; material, social and human capital; and discrimination) were identified within genetic, personal, organizational, societal, and macro-social domains. Together, these factors create an environment that fosters and or hinders the development of public health leadership via multiple pathways of social integration, social support, and increased access to power, information, and resources.

Conclusions: This multi-factorial framework may provide a viable new perspective for understanding the etiology of leader development, performance and motivation—one particularly appropriate for the dynamic, knowledge-based practice of public health and medicine.