Leading Collaboratively for Lasting Public Health Impact

June 15, 2026

Across the United States, public health systems navigate complex challenges such as rising demand, limited resources, persistent health disparities, and the need for cross-sector coordination. These challenges span health care systems, policy environments, and communities.

For public health leaders, this reality reshapes how leadership itself is defined. Impact is no longer defined by individual expertise alone, but by the ability to align people, systems, and strategies toward shared goals. Collaborative leadership is essential to building sustainable, equitable public health systems.

Chelsea Moriarty Coffield, MD, MBA and Aracely Macias, MPH, members of ASTHO’s Developing Executive Leaders in Public Health (DELPH) program, bring complementary perspectives to this work. While their roles differ, both emphasize a shared truth: meaningful progress depends on intentional, structured collaboration.

“Public health challenges are too complex for any single person or organization to solve alone,” said Coffield. “Real progress happens when we bring different perspectives together and trust people to contribute their expertise.” Macias echoed this from a systems perspective: “If we are serious about health equity, the work cannot live in one program or one office. It must be shared, structured, and sustained across government.”

Tell us about yourself and your role.

Coffield is a public health strategist who leads large-scale, cross-sector initiatives designed to address the root causes of health disparities. At Harris County Public Health, she oversees the Community Health Assessment and Community Health Improvement Plan, aligning government agencies, health care providers, and community organizations to drive coordinated, system-level solutions.

Macias serves as a Strategic Advisor in the Office of Minority and Multicultural Health at the New Jersey Department of Health, where she focuses on advancing health equity through policy and cross-department collaboration. Her work centers on strengthening alignment across programs and building sustainable infrastructure, including efforts to develop a department-wide language access program.

Although their roles operate at different levels of the public health system, both describe their work in similar terms: bringing together diverse stakeholders, navigating complexity, and building systems that are stronger than any individual effort. As Macias put it, “Everyone brings a different piece of the puzzle, and the work is stronger when those pieces are brought together intentionally.”

Why did you decide to apply for DELPH?

Coffield was drawn to strengthening her capacity for transformational leadership and systems-level change. “Public health challenges require policy alignment, strategic partnerships, and the ability to mobilize resources across systems,” she explained.

Macias shares a similar motivation but frames it through structure and sustainability. “Collaboration is happening across public health agencies, but it’s not always defined or built to last,” she said. “I wanted to strengthen how it is structured, supported, and positioned for long-term impact.”

Together, their perspectives reflect a broader national context: public health leaders across the country are navigating similar constraints, and learning across jurisdictions is critical to identifying scalable, sustainable solutions.

What are highlights of the DELPH program for you so far?

One of the most meaningful aspects of the DELPH experience has been the opportunity to learn from peers across the country. “Sometimes you’re the only person in your department working on a particular issue,” Coffield noted. “That can feel isolating.” Macias agreed, adding that the program provides both connection and practical tools: “It’s been helpful to see how others are approaching similar challenges and to have frameworks we can apply more intentionally.”

In many ways, DELPH serves as both a support system and a learning lab, creating shared purpose while strengthening how collaboration is applied in practice.

Tell us about your approach to collaboration. What leadership principles guide you?

Both leaders center their approach on a core principle: no single person or team has the full picture.

For Coffield, effective collaboration starts with trust. “When people know their expertise is respected, they are more willing to share ideas and challenge assumptions,” she said. Macias complements this with an emphasis on structure and accountability. “If we are not aligned on what success looks like, then we are working alongside each other, not truly collaborating,” she explained. “It has to be built into how we operate.”

Their perspectives highlight two critical dimensions of collaboration: creating environments where people feel empowered to contribute and building systems that sustain that collaboration over time.

Why is collaborative leadership important to you?

In public health, collaboration is not just helpful, it is essential. Public health systems are incredibly complex, shaped by more than a century of policy decisions, social dynamics, and economic forces.

Coffield: “Our role as leaders is to create an environment where all of those perspectives can come together to generate innovative solutions.”

Both participants describe collaborative leadership as essential to addressing the scale and complexity of public health challenges. Collaborative leadership is what allows public health efforts to move beyond short-term initiatives and become sustained systems.

“I’ve seen the difference in the quality of the work when collaboration is done well,” Macias said. She pointed to the 35-year legacy of the Office of Minority and Multicultural Health as a clear example. “That work started because people came together across sectors and made a commitment to address disparities. Thirty-five years later, we are still building on that foundation. That does not happen by chance. It happens because collaboration was built into the work from the beginning.”

Collaboration is what allows public health efforts to move from isolated activities to coordinated, system-wide change.

How are you using collaborative leadership to address challenges in your agency?

While their approaches reflect different roles, both leaders focus on building alignment in complex environments. Effective collaboration requires meeting people and systems where they are and building forward intentionally.

Coffield begins with people. “I start with what motivates the team, what excites them and where they want to contribute,” she explains. “When people feel invested, they bring more creativity and persistence to the work.”

Macias focuses on systems. “We’re identifying what already works and building toward greater consistency without adding burden,” she says. Her approach emphasizes alignment across programs while respecting existing processes and constraints. “It is complex and iterative. But it reinforces that collaboration is about bringing the right people together to build something that is stronger than what any one team could do on its own.”

How do you build trust and encourage open communication?

Macias focuses on creating inclusive environments where people feel comfortable contributing. “It’s okay to not have all the answers and to try something that may not work the first time,” she said.

Coffield emphasizes modeling that openness. “If I want my team to ask questions and challenge ideas, I have to demonstrate that behavior myself,” she explained. She also underscores the importance of clearly defining the purpose of the work: “People need to understand the ‘why’ — what we’re trying to solve and what success looks like.”

These approaches point to a shared understanding: trust is built through transparency, psychological safety, and clarity of purpose.

What lessons have you learned from challenges in your leadership journey?

Over time, each leader has shifted away from perfectionism toward a more adaptive mindset.

“I thought I always needed to have the right answer,” Coffield reflected. “Letting go of that made me a more flexible and collaborative leader.”

Macias shared a similar perspective: “This work is constantly evolving. It’s better to move forward, learn, and refine than to wait for perfect conditions.”

What advice would you give to others trying to lead more collaboratively?

Coffield’s and Macias’ advice is centered on inclusion and intentionality.

Coffield emphasized listening and empowerment: “Start with the people closest to the problem. They often have the most valuable insights.”

Aracely reinforced intentionality and structure: “Bring people in early, be clear about the purpose, and build collaboration into how the work operates.”

Their guidance converges on a simple but powerful idea: collaborative leadership is not about directing the work — it is about creating the conditions where shared ownership and innovative ideas can emerge.

Final Reflection

Collaborative leadership is not simply about working together — it is about building systems that align people, resources, and strategies for sustained impact.

Whether operating at the local or state level, Coffield and Macias demonstrate that the future of public health depends on leaders who can bridge silos, center shared goals, and design collaboration that lasts.

Reviewed by Avia Mason, Vice President, Leadership and Learning; and Kristin Sullivan, Director, Public Health Systems Improvement and Infrastructure.