MINORITY FACULTY DEVELOPMENT Volume 11-Winter 2002

Leadership Forum: Joxel Garcia, MD, MBA
by Phillip Wodzinski

Joxel Garcia, MD, MBA, began an MFDP-sponsored Leadership Forum on the theme of “Leadership, Social Marketing and Urban Health,” presented on October 2, 2001 by saying, “Without healthy people and communities, we can never hope to achieve economically and socially vibrant cities.” Dr. Garcia, Commissioner of the State of Connecticut’s Department of Public Health (DPH), relied on the diverse components of his medical training, business experience, and ethnic background to illustrate his view on the tasks of public health officials in the coming years.

With the principle that leadership is “finding out how to communicate and transmit your vision” to an audience, Dr. Garcia offered his vision for the future of public health in Connecticut. This vision includes the threefold task of “reinventing the DPH to address the health challenges facing the residents” of his state, “maximizing public health service to citizens”, and taking a more visible “position as a leader of health and human services on state, regional, and national levels.” A key to all three elements of this vision is to note the large population shifts in Connecticut and further to observe that public health services do not reflect these shifts: the health of various minority populations is far worse than that of the white population.

Dr. Garcia did not assign blame for these public health disparities but did offer realistic solutions, which he gathered under the label of “social marketing.” Social marketing, a term obviously referring to Dr. Garcia’s dual background of medicine and business, involves understanding the “customer needs” of one’s target audience and then “making the product available.” To understand the needs of one’s target audience one must gain a clear knowledge of its social and demographic makeup and its psychosocial features, or else the would-be leader/provider will remain ignorant of the true needs of that audience. Furthermore, in order to ensure that the target audience receives what it needs, the leader/provider must use both the promotional possibilities of mass media as well as interpersonal contact. Otherwise, a target audience, even if its needs are known, might continue to exist without being aware that those needs can and will be satisfied.

With this link between medicine and business, services and communication, Dr. Garcia reached the core of his message. Social marketing requires three “P’s”: Partnership, Policy, and Politics. The presentation focused on the first of these. Partnership is a necessity because “social and health issues are complex and require a team effort to create change.” A noteworthy example of Dr. Garcia’s partnership efforts is his creation of the Department of Public Health’s Office of Workforce Development, which collaborates in its public health efforts with the Governor’s Office of Workforce Development. These two separate government offices focus together on urban centers in terms of short-term goals, like increasing urban students’ applications to health care programs, and long-term goals, like eliminating the nursing shortage, forecasting market trends of public health care needs, and arranging for the workforce to match the demographics of the population. Other partnerships with faith-based organizations, community action groups, educational institutions, and other social groups is not only possible but necessary if one wants to fulfill the kind of vision offered by Dr. Garcia.

Nevertheless, Dr. Garcia concluded, a leader’s partnerships, resources, and opportunities will not be well used if they do not apply directly to those who need them in the first place. To ensure this application, a leader in public health must extend the partnership to the public itself.

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The next Leadership Forum featuring Lois Stokes, JD, is Tuesday, February 12, 2002. Visit our on-line Community Outreach and Diversity Calendar at www.mfdp.med.harvard.edu/calendar for more information.