Chronic Disease Prevention as an Adaptive Leadership Problem

One of my colleagues from the Department of Public Health (DPH) was with me. We had been talking about the work we had just performed with a nearby school district. Then we saw the house the students entered. It was a manufactured home in poor repair, with plastic over the windows. The yard was overgrown. There were no working vehicles in sight, and it struck me that two adults were home in the middle of the afternoon. It would be several more miles before we saw a sign for a grocery store or a local county health department where someone might find services related to family planning, education programs for self-management of chronic diseases, or preventive screenings. It was an hour before we saw a sign for a hospital. As we drove on toward Atlanta, we were quiet, thinking about the challenges that family was likely facing.