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Leadership – Lean – Data science

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Our comforting conviction that the world makes sense rests on a secure foundation: our almost unlimited ability to ignore our ignorance. … Daniel Kahneman1 How you actually make decisions will surprise you. The vast majority of intuitive decisions we make everyday as individuals and as teams are driven by nonconscious mental and emotional processes. Unless we have the courage and humility to learn about, leverage, and mitigate these processes to make better decisions, we will be vulnerable to “our almost unlimited ability to ignore our ignorance.


Kudos to Cyndy Comerford and Max Gara from the San Francisco Department of Public Health, Health Impact Assessment (HIA) Program! Also, special acknowledgments to Michelle Kirian and Erik Dove for their important contributions. Excerpt from the Executive Summary On November 8, 2016, California voters passed Proposition 64, the “Adult Use of Marijuana Act.” This proposition made it legal for individuals age 21 and older to use, possess, and make non-medical cannabis available for retail sale.


Check out the video by Mehroz Baig from the Center for Learning and Innovation, Population Health Division, San Francisco Department of Public Health to hear how Bay Area social justice and public health experts think we can move this conversation forward. “Diseases don’t discriminate. Diseases also don’t operate in a vacuum. Public health professionals have seen disparities in health outcomes along racial and ethnic lines for decades. Data point to disparities in life expectancy, rates of new HIV diagnoses, rates of viral suppression for those who are HIV positive, rates of emergency room visits due to asthma or heart disease, among others.


Several years ago I (TJA) developed the ‘epitools’ R package for epidemiologic data and graphics. My goal was to have a practical package for practicing epidemiologists at local and state health departments. It was designed to conduct contingency table analyses for outbreak investigations, to construct epidemic curves, to improve graphical color selection, to implement basic methods from Chapter 4 of Rothman’s Modern Epidemiology, and more. Recently, ‘epitools’ maintenance was taken over by Adam Omidpanah from the Washington State University.


Leading transformation The Leading Population Health Framework (LPHF) is based on pursuing and acheiving essential population health goals: protecting and promoting health and equity, transforming people and place, ensuring a healthy planet, and achieving health equity. Population health continuous improvement requires leadership and transformation (Figure 1): a population health leadership philosophy,1 transforming self and interpersonal relationships, transforming teams and collaboratives, and transforming organizations and communities. Figure 1: The Leading Population Health Framework (LPHF) is based on a leadership philosophy and three necessary transformations.


Humility is the key to unleashing and supercharging personal and organizational performance improvement. However, not everyone feels comfortable introducing complex topics like cultural humility. I was fortunate to discover Professor Edward Hess’ book “Humility is the New Smart: Rethinking human excellence in the smart machine age.”1 I believe his book is a non-threatening, practical, and inspiring way to introduce humility to your staff. Based on Hess’ book, the article below is an excerpt from our population health lean reference document.


Building trust In organizations with high trust levels staff engage in honest, vigorous deliberations about important and sensitive topics, including strategy, budget cuts, ethics, equity, racism, discrimination, power, privilege, prejudice, interpersonal conflict, etc. The word trust is used often but rarely defined. The word is thrown around as if everyone understands exactly what we mean. We attend countless meetings where “building trust” is emphasized. Building and restoring trust requires a thoughtful, systematic approach.


In 1998, Melanie Tervalon and Jann Murray-García published a groundbreaking article1 that challenged the concept of “cultural competency” with the concept of “cultural humility.” Cultural humility is committing to lifelong learning, critical self-reflection, and personal and institutional transformation. Accepting cultural humility means accepting that we can never be fully culturally competent. Cultural humility is the foundation for establishing trust and respectful relationships, and for managing differences and conflict. Cultural humility means


Key projects

Applied Epidemiology with R

Public Health 251D, University of California, Berkeley School of Public Health

Leading population health

Practical skills for transforming self, teams, organizations, and communities.

Population health data science with R

The art and science of transforming data in actionable knowledge to improve health.

Population health lean

A management system for continuous learning, improvement, and innovation based on lean thinking, leadership, and practice.

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