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How to Lead ThroughPublic Healths Controversial Waters

Dora Anne Mills, MD, MPH

Director, Maine CDC/DHHS

November, 2008

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We all have personal opinions, religion

and politics, but the Surgeon General

communicates based on the bestavailable science.

- Dr. David Satcher, July 2007

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Some Tools to Address

Public Health Science

Leadership styles

Social marketing strategies

Understand common strategies we

are countering

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All Tools Take Leadership

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Leadership That Gets Results

Daniel Goleman

Harvard Business Review

August, 2000

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Studied over 3,000 executives

6 leadership styles

Exemplary leaders use 4-6 styles

Choosing the most appropriate for the

individual situation

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6 Leadership Styles

Authoritative mobilize people toward a vision

Affiliative create emotional bonds and harmony

Coaching develop people for the future

Democratic build consensus through participation

Pacesetting expect excellence and self-direction

Coercive demand immediate compliance

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Tools to Promote Science

Education using scientific information

Policies/laws

Social Marketing

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Social Marketing

A tool when science is not enough

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Social Marketing

Why are people not taking action?

Reduces barriers to action

Promotes benefits

In the eyes of the audience

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Social Marketing-Related Questions to

Ask When Faced with Dilemmas:

Who needs to take action?

What action?

What are the benefits of action?

What are the barriers to taking action? (including

competitive promotion)

How to best reach audience when and where?

What methods to reach audience?

Who - what spokespeople are the most effective?

What partners can help?

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Vaccines and Thimerosal

Dilemma:Leg islat ive hearing to ban

thimerosal-containing vaccines

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Health Officials Discuss Link Between Autism, Flu Vaccine

9/21/2005

Thimerosal isn't safe

April 17, 2006

Is there a link between autism and vaccination?

Legislatures considering bills that would ban thimerosal


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Strategies used by proponents

Pseudo-science e.g. loose associations

Policies

Web and other networking

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Who needs to take act ion?

Primary: Legislators

Secondary: Parents

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What act ion?

Vote against a ban on thimerosal in

vaccines

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Benef i ts?

Vaccines will be more available

especially for emergency situationssuch as pandemic, snake bites, travel

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Barr iers?

A room full of passionate mothers and

autistic kids and a desire to dosomething about this tragic situation

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How?

Hearing at the Legislature

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Strategies?

Acknowledge frustration and emotion

in the room

Shift passion to common ground no

tracking data for autism

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By Whom?

Maine

Autism Society of Maine

Medical/Pediatric Associations

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Mos t effect ive leadersh ip sty les

Affiliative

Democratic

Authoritative

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Fluoride

Dilemma:Bar Harbor votes to ban

community water fluoridation.

Bangor City Council schedules

hearing on the subject.

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Maine CDC

Town says no to fluoride

Bar Harbor Times

March 7, 2007

Unreasoned Fears Of Flouride

Down East Magazine

June, 2007

Giving Fluoridation Teeth

March 19, 2007

Mount Desert Fluoride Vote Sparks DebateIsland Institute

September 24, 2007


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Pseudo-science

Policies


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Fluoride


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Fluoride


Primary: Bangor City Council

Primary:All municipal policymakers

across Maine

Secondary: General public

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What act ion?

Vote against a ban on fluoride

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Fluoride

Benef i ts?

Teeth and overall health are stronger

Health care costs reduced

Fewer people with poor dentition

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Fluoride

Barr iers?

Fear misinformation sounds so

credible

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Fluoride

How?

Immediate

Statewide

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Fluoride

Strategies?

Press

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Fluoride

By Whom?

Maine and every other major

health organization

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Fluoride


Authoritative

Democratic

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Abstinence Only Education

Dilemma:Want to stand for science

and reject Federal A-O funds

after accepting the funds

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Maine CDC

Maine Rejects Federal Abstinence-only

Sex-ed Funds

September 23, 2005

Maine Declines Federal Funds for

Abstinence-Only Sex Education

Programs, Says New Guidelines

Prohibit 'Safe-Sex' Curriculum

September 21, 2005

US state rejects federal funding for

abstinence only sex education

October 1, 2005

Maine right to abstain from

funds with a catch

September 21, 2005


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Pseudo-science

Policies

Web and other networking, including

religious organizations

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Need policymakers to support

Governors decision to reject FederalA-O funds

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What act ion?

Need them not to take any action

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Benef i ts?

A-O Funds do not work and can do our

youth harm:

Forces a gag order on full information

(youth with full information, that includes

abstinence, are more likely to make the

healthiest choices for their situation)Sends harmful messages to some kids

(gay students, etc.)

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Barr iers?

Monetary (turning back Federal funds)

Angers those who agree with A-O

approach

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How?

Press

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Strategies?

Press conference with many health

and education partners

Many collateral opinion pieces

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By Whom?

Maine and health and education

leaders Family Planning, many healthand education partners, faith-based

organizations, etc.

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Authoritative

Democratic

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Lyme Disease

Dilemma:Lyme Disease advocates want

insurance coverage for non-standard

treatments and legitimacy (links from

our websites, etc.)

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Maine CDC

Living With Lyme Disease

May 17, 2007

'Legend of North Country' Bill Chinnock

dies at 59

March 9, 2007

PHOTO GALLERY

Chinnocks Lyme disease activism hailed

By The Associated Press

March 19, 2007

Lost to Lyme

March 18, 2007
mailto:[email protected]:[email protected]:[email protected]:[email protected]


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Pseudo-science

Policies


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Lyme Disease


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Lyme Disease


Primary: LegislatorsSecondary: General Public

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What act ion?

Reject current legislation to require

insurance

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Lyme Disease

Benef i ts?

Reduce growth of antibiotic resistance

that can harm all of us

Reduce harm to individuals of antibiotic

overuse

Reduce costs of insurance

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Lyme Disease

Barr iers?

Perception that people need chronic

intravenous antibiotics

A few physicians are supportive of this

non-standard approach

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How?

Legislative hearings

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Strategies?

Legislative hearing

Letters and phone calls to legislators

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Lyme Disease


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Lyme Disease

By Whom?

Maine

Infectious disease physicians in Maine

Medical Associations (MMA, MOA)

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Lyme Disease


Authoritative

Affiliative

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