MPH 570 Week 6 Leadership for Sustainable Policy Change Example

Keeping the License Alive: Adaptive Leadership to Sustain a County Tobacco Retail Ordinance Through an Election, Turnover and a Repeal Attempt

[Student Name]

University of Phoenix

MPH/570: Public Health Policy and Leadership

Week 6 Assignment

[Instructor Name]

[Date]

The county, its leaders, compliance figures, election and repeal proposal are composites written for a model paper; research findings come from the sources cited.

Two years after the county adopted its tobacco retail license, the results were encouraging: every licensed retailer had been checked at least twice a year, and the share of compliance checks resulting in a sale to an underage buyer had fallen from 14% before the ordinance to 6%. Then a new commissioner, elected on a small-business platform, proposed repealing the license as unnecessary regulation. The coalition that passed the ordinance had shrunk, the original champion had retired and the health director who led the effort was new in her second year. This paper examines the leadership needed to sustain the policy.

Why Sustaining Is Harder Than Passing

Adoption brings attention and energy; sustaining a policy happens after the news coverage ends. Supporters move on, opponents remain, budgets tighten and newly elected officials may not know why the policy was adopted. Many public health policies weaken not through dramatic repeal but through quiet neglect.

Technical and Adaptive Challenges

Adaptive leadership separates two kinds of problems. Some are technical: experts already know the fix and can apply it. Others are adaptive: no fix works until the people involved shift what they believe, value or habitually do. Scheduling compliance checks is technical. Persuading a new commissioner, and the constituents behind him, that the license is worth keeping is adaptive, because it touches values about government and business.

Evidence on Leadership Development

Adaptive leadership can be learned. An evaluation of a pilot adaptive leadership academy for public and community health executives, based on surveys and interviews with 20 participants, found that the program improved leadership knowledge, skills and capabilities, and participants valued the cohort model and synchronous sessions that created a supportive environment for growth (Hall et al., 2024). The director had completed a similar program and drew on it.

Framing the Ordinance

The director framed the license as a structural change rather than a program. The health impact pyramid places interventions that change the context, making healthy defaults easier, near its base, where they reach broader populations and require less individual effort than education and counseling (Frieden, 2010). A license that reduces sales to minors works for every young person, whether or not they attend a prevention class.

The Case for Persistence

Effects of youth access policies build over time. Needham, Massachusetts, offers a lesson in patience: four years after its sales age rose, the town's rate of high schoolers smoking in the past month had nearly halved, from 13% in 2006 to 7% in 2010, a significantly greater decline than in comparison communities, while youth alcohol use showed no similar difference (Kessel Schneider et al., 2016). A policy repealed after two years never has the chance to show its full effect. The county's student survey, due the following year, would provide the first local evidence on use. Repealing the license before those results arrived would discard the investment just as its payoff could be measured.

Shared Leadership

The response did not rest on the director. The sheriff described the enforcement results and the modest staff time required. A grocery owner who had supported the ordinance described fair treatment of retailers. Youth researchers presented their findings on advertising near schools. Parents from the original coalition spoke at a public meeting. Each brought credibility the health department alone lacked.

Reading the Political Change

The election changed the board's composition but not necessarily residents' views. The coalition's informal survey of parents at school events found strong support for keeping the license, and most retailers in the advisory group preferred the stability of a known system to a new change. The director concluded that the repeal proposal reflected the new commissioner's campaign promise more than a shift in community opinion, which suggested engagement rather than confrontation.

Engaging the New Commissioner

The director asked to meet the new commissioner, listened to his concerns about regulatory burden and shared data on compliance, fees and retailer satisfaction from the advisory group. She offered to simplify the renewal process, a technical fix that addressed a real complaint without weakening enforcement.

Holding Steady Under Pressure

Adaptive leadership asks leaders to regulate the heat: enough pressure to keep people engaged with a hard question, not so much that they retreat. The director resisted calls from some coalition members to attack the new commissioner publicly, which would have hardened positions. Instead, she kept the conversation on results and fairness, and gave him a way to support the ordinance by improving it.

Mobilizing Without Campaigning

As a public employee, the director provided information but did not campaign. The coalition, rebuilt with new parent and youth members, organized testimony and constituent contacts. Keeping roles clear maintained the department's standing with all commissioners.

The Outcome

At the hearing, the repeal proposal failed three to two, and commissioners adopted the simplified renewal. One commissioner who had voted against the original ordinance voted to keep it, citing the compliance data and the sheriff's testimony.

Succession Planning

The episode showed a vulnerability: much knowledge sat with a few people. The department documented the ordinance's history, data and partner contacts, cross-trained two staff, rotated coalition leadership and created a youth leadership pipeline so that graduating students recruit their successors.

Using Data to Maintain Support

The annual public report now leads with three numbers: retailers checked, the compliance failure rate and fee revenue covering enforcement. Commissioners receive the report before budget discussions, keeping the policy visible.

Preparing for the Next Threat

The team listed other threats: state legislation that might preempt local licensing, a budget crisis that could divert fee revenue and staff turnover in the sheriff's office. For each, it named an early warning sign and a first response, such as monitoring bills during the legislative session and keeping the fee revenue in a dedicated account.

Equity and Legitimacy

Sustained support depends on fairness. Reporting compliance by area and showing that small stores were not singled out answered concerns raised by the east side commissioner and retailers alike.

Personal Leadership Lessons

The director drew several lessons. She had initially treated the repeal threat as a technical problem of presenting data; she learned it was adaptive, requiring her to listen to values she did not share. She relied too long on a small group of veterans; she now invests in new leaders. She will seek coaching on political communication and join a peer network of health directors over the coming year.

Conclusion

Sustaining the tobacco retail license required leadership different from passing it. Adaptive leadership separated technical fixes from value conflicts, the health impact pyramid framed the ordinance as structural change, evidence on long-term effects justified persistence and shared leadership among the sheriff, retailers, youth and parents defeated the repeal. Succession planning, public data and personal growth are the tools that will keep the policy alive when today's leaders move on.

References

Frieden, T. R. (2010). A framework for public health action: The health impact pyramid. American Journal of Public Health, 100(4), 590-595. https://doi.org/10.2105/AJPH.2009.185652

Hall, K., Bardier, C., Greer, D., Clayton, A., & Poblete, R. (2024). Unleashing leadership potential in unprecedented times: Lessons learned from an evaluation of a virtual cohort-based adaptive leadership program for public health executives. Public Health in Practice, 8, Article 100532. https://doi.org/10.1016/j.puhip.2024.100532

Kessel Schneider, S., Buka, S. L., Dash, K., Winickoff, J. P., & O'Donnell, L. (2016). Community reductions in youth smoking after raising the minimum tobacco sales age to 21. Tobacco Control, 25(3), 355-359. https://doi.org/10.1136/tobaccocontrol-2014-052207