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Tensions and opportunities in the roles of senior public health officials in Canada: A qualitative study.

ABSTRACT: Although public health emergencies like the COVID-19 pandemic thrust senior public health officials into the spotlight, their day-to-day roles remain misunderstood and under-examined. In jurisdictions that follow the Westminster system of government such as Canada, the United Kingdom, and Australia, Chief Medical Officers of Health (CMOHs) are typically senior public servants who are simultaneously positioned as public health professionals with independent expertise, senior advisors to an elected government, and designated protectors of the public health interest. Using Canada's federal and provincial CMOHs as case studies of this role in Westminster governments, we analyzed in-depth key informant interview data to examine how CMOHs navigate the tensions among their duties to the government, profession, and public in order to maximize their public health impact. We demonstrate that CMOHs are variously called upon to be government advisors, public health managers, and public communicators, and that the different emphasis that jurisdictions place on these roles shapes the tools and pathways through which CMOHs can influence government action and public health. We also elucidate the tensions associated with having CMOHs positioned within the senior levels of the public service and the strategies these officials use to balance their internal- and external-facing roles. Finally, we highlight the trade-offs among different institutional design options to inform decisions about the structure of the CMOH position in different contexts.

SUBMITTER: Cassola A

PROVIDER: S-EPMC9296232 | biostudies-literature | 2022 Oct

REPOSITORIES: biostudies-literature

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Tensions and opportunities in the roles of senior public health officials in Canada: A qualitative study.

Cassola Adèle A Fafard Patrick P Nagi Ranjana R Hoffman Steven J SJ

Health policy (Amsterdam, Netherlands) 20220720 10

Although public health emergencies like the COVID-19 pandemic thrust senior public health officials into the spotlight, their day-to-day roles remain misunderstood and under-examined. In jurisdictions that follow the Westminster system of government such as Canada, the United Kingdom, and Australia, Chief Medical Officers of Health (CMOHs) are typically senior public servants who are simultaneously positioned as public health professionals with independent expertise, senior advisors to an electe ...[more]

PMID: 36002358

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Tensions and opportunities in the roles of senior public health officials in Canada: A qualitative study.

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Tensions and opportunities in the roles of senior public health officials in Canada: A qualitative study.

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