Michigan Office of the Surgeon General: A case study and lessons learned

Michigan was the first state to create an Office of the Surgeon General (OSG) in 2003. Established by Governor Jennifer Granholm, a state-level Surgeon General was unique among initiatives nationwide advocating and implementing a strengthened public health leadership and infrastructure. The Michigan Public Health Training Center and the Center for Law, Ethics, and Health at the University of Michigan collaborated with the OSG to investigate its inception, development, and accomplishments, and to assess progress in achieving goals from 2003 to March 2006. As reflected in the report created for the Michigan Department of Community Health and the OSG, our presentation will provide background and lessons learned highlighting the opportunities and challenges in implementing this new state-level office for public health leadership. Our findings and conclusions are based on ~45-minute semi-structured interviews (n= 19), and a focus group with key stakeholders representing persons and groups affected by or involved in the creation of the Office and its implementation, especially state government, state and local public health agencies, business, media, academe and health care systems; as well as interviews with former U.S. Surgeons General. Our results suggest that just as external factors such as political feasibility, autonomy, organization, and fiscal sustainability will shape the experience of the OSG, this state-level leadership post is an innovative strategy for integrating and coordinating public health promotion and integrating public health activities.