Public Health in Turbulent Times (UCSD SPH 2025 Commencement Address)
Becoming a Learning, Healing, and Impactful Leader
Herbert Wertheim School of Public Health and Human Longevity Science 2025 Commencement
Thank you, Dean Anderson, for your inspiring, compassionate leadership, and for inviting me to speak today. It’s truly an honor to stand before the graduating class of 2025 at the UC San Diego Herbert Wertheim School of Public Health and Human Longevity Science. (YouTube recording)
To the graduates: congratulations! You have persevered through unprecedented challenges — academic, personal, community, and global. You have earned this moment. I also want to acknowledge the faculty, students, and staff whose dedication, innovation, and resilience have advanced public health and health equity in California and beyond, especially during our collective response to the COVID-19 pandemic and other public health threats.
And, of course, I want to thank the families, friends, and loved ones who have supported you on this journey. You are the foundation upon which our graduates have are building their futures.
Personal background
Let me begin by sharing a bit about my own journey. My family immigrated from Nicaragua in the 1950s and settled in San Francisco’s Mission District, a vibrant, low-income Latino community with a high concentration of Central American immigrants. My mother completed only a sixth-grade education, worked as a seamstress in sweatshops, and raised four children as a single parent. We struggled financially. As a child, I delivered newspapers and made burritos at Paco’s Tacos on the corner of 24th Street and South Van Ness Avenue.
When I would ask my mom what she wanted for Mother’s Day, she always replied, “The only thing I want is for you to be a good person.” “Okay!,” I thought, “I can do that!” Even though we were materially poor, I always felt loved, supported, and accepted. Through trial and error, I eventually discovered public health and medicine.
For more than 25 years, I have practiced governmental public health1 in multiple roles and at every level — from working with communities on environmental justice, to responding to the COVID-19 pandemic and to running the largest state health department at the height of the pandemic.
Throughout my journey, my theory of change has been about learning how to transform organizations. My hypothesis has been: “If I can get my team of 4,500 staff to improve their game, then collectively they will accomplish much more than I could ever accomplish in my lifetime.”
Health Leadership Trivium — An introduction
Today, I want to share with you three concepts for transforming organizations — concepts that work by transforming individuals and teams. These are what author Steve Tierney2 calls a “leadership trivium.” In Latin, trivium means “the place where three roads meet.”3 A leadership trivium consists of three concepts that are interdependent, synergistic, and generative.
We are Team Public Health!
In fulfilling our purpose to protect and improve health for all, our job is to become learning, healing, and impactful individuals, teams, and organizations. We cannot leave one out — it must be all three — learning, healing, and impactful. They can be applied anytime, anywhere, and at any level to transform self, teams, organizations, and communities. The trivium works because it activates and deploys the fundamental human attributes of cognition, emotion, and behavior — knowing, being, and doing.
Learning: In a learning team, we strive to become “the best at getting better” by embracing intellectual humility, science, continuous improvement, and innovation.
Healing: In a healing team, we “prevent harm and promote healing” by preventing toxic stress and trauma, promoting equity and justice, and cultivating cultural humility.
Impactful: In an impactful team, we protect and improve health and well-being for all by setting aspirational goals, measuring what matters, and holding ourselves accountable.
This leadership trivium is foundational to public health. I will return to each of them after briefly describing the current challenges we face.
Context and public health challenges
World historian Yuval Noah Harari reminds us that, as a global community, we face three existential threats:4 5
Ecological Collapse from our failure to address climate change, extreme weather events, and environmental pollution such as microplastics.
Technological Disruption such as artificial intelligence, which is evolving at a pace and scale never seen before, and which can lead to great benefits and great harms.
And, Escalating Human Conflicts, including nuclear war, from our inability to resolve conflicts and build enduring peace.
Sadly, from our current federal government, we are experiencing draconian policies of retribution, othering, and dismantling of health and human services programs, research, and training.6 7 Othering is the process of defining individuals or groups as “other” — different, inferior, less deserving, or a threat — thereby denying their and our full humanity and dignity.
Othering is the process of defining individuals or groups as “other” — different, inferior, less deserving, or a threat — thereby denying their and our full humanity and dignity.
For communities still recovering from the COVID-19 pandemic and climate-related disasters, these structural sources of adversity are piling up, leading to chronic toxic stress, trauma, anxiety, depression, and “diseases of despair” such as isolation, loneliness, addiction, and suicide.8 Trust in each other, and trust in government, science, and public health has declined.
Given our current situation, YOU are needed now more than ever. In public health, we do not always choose our challenges, but we do choose how to respond to them. We need to be the strongest, best versions of ourselves to tackle these public health challenges.
Health Leadership Trivium — The details!
1. Learning: Becoming the Best at Getting Better
Back to the leadership trivium!
The first category is LEARNING.
Becoming a learning team means “becoming the best at getting better.” This is what we expect of our doctors, teachers, and even our professional sports teams. And, yes, this is what we should expect of ourselves.
First, cultivate intellectual humility. Intellectual humility is recognizing and owning your intellectual limitations in service of pursuing deeper knowledge, truth, and understanding through curiosity and inquiry.9 Intellectual humility generates and powers the growth mindset. In the words of fictional English soccer coach, Tess Lasso, “be curious, not judgmental.” Curiosity is a superpower that accelerates your learning!
Second, stress test your ideas (and beliefs) by seeking candid, honest feedback. Nobel laureate Daniel Kahneman was renowned not only for his groundbreaking research but also for his insatiable curiosity — he embraced being proven wrong. He famously remarked, “No one enjoys being wrong, but I do enjoy having been wrong, because it means I am now less wrong than I was before.” Ask yourself, “How could I be wrong?” “What am I missing?”
And third, master AI to promote human flourishing. Use AI to challenge your assumptions, sample knowledge from your “known unknowns” and “unknown unknowns,” close your blind spots, and mitigate your confirmation bias. Used correctly, AI promotes intellectual humility because we quickly discover how little we actually know, and the limitations of our logic, reasoning, and analysis.
So what is AI? It’s not what you think. AI stands for Appreciative Inquiry10 — the human-centered practice of inquiry and transformation through conversations that add value to human relationships. Appreciative Inquiry is also a framework to guide how to use artificial intelligence — the other “AI” — to improve learning, co-creation, and transformation. Prioritize mastering relationships with “human agents” over “artificial intelligence (AI) agents”!
2. Healing: Preventing Harm and Promoting Healing
The second category of the health leadership trivium is HEALING.
Adversity, toxic stress, and trauma are growing. Trauma is exposure to an event or environment that is experienced and has a lasting negative effect. Whether we recognize it or not, we are all affected. Trauma is universal. We may experience primary, secondary, or vicarious trauma. Vicarious trauma occurs by consuming too much news and information about traumatic events.
To prevent harm and promote healing:
First, take care of yourself. At CDPH,11 we have a saying: “Rest is not a reward, it’s a requirement.” Prioritize rest and recovery. Get enough sleep. Schedule walks in nature with family or friends. Nurture positive social connections. Avoid sources of vicarious trauma — Disconnect from upsetting news or social media.
Second, take care of each other. Dealing with adversity is possible when we have adequate resources, capabilities, and support. Be that support for each other. How do we do it? Again, “Trauma is exposure to an event or environment that is experienced and has a lasting negative effect.”12 Focus on preventing and mitigating the E-words: exposure, event, environment, experience, and effect.
Third, create belonging WITHOUT othering. Humans crave to belong to a community. Unfortunately, as we are seeing today, some create “belonging BY othering.” Instead, we aspire to build a community of belonging that is more than just feeling included; it’s a deep sense of connection, dignity, and the right to co-create and participate meaningfully in society. Belonging implies mutual power, access, and opportunity for all individuals and groups within a community to human well-being and a just society.
Belonging occurs:
When we are included.
When we have agency and are empowered to co-create our journey.
When we are recognized by being seen and heard.
When we feel connected to each other.
Belonging occurs when we are included, have agency, are recognized, and feel connected.
Belonging without Othering13 requires what UC Berkeley Professor john a. powell calls bridging. Bridging14 is the practice of building connections, understanding, and solidarity across lines of difference, even those that seem difficult to reconcile. It involves empathetic listening, recognizing our shared humanity, and working to create a larger “we” that honors diversity without demanding assimilation. It’s about moving from conflict and division towards connection.
Bridging is the practice of building connections, understanding, and solidarity across lines of difference, even those that seem difficult to reconcile.
Fourth, in the words of my mother, be a good person. Be kind. Be humble. My favorite definition of humility is from religious scholar John Dickson:15 “Humility is the noble choice to forgo your status and to use your influence for the good of others before yourself.” In other words, “Humility is to hold power in service of others.” If character is a tree, the roots are humility. The deeper the roots, the stronger your character.
“Humility is the noble choice to forgo your status and to use your influence for the good of others before yourself.”
3. Impactful - measure what matters
Finally, the third category of the health leadership trivium is being IMPACTFUL.
In an impactful team, we protect and improve health for all by setting aspirational goals, measuring what matters, and holding ourselves accountable. Sociologist William Bruce Cameron16 wrote, "Not everything that counts can be counted, and not everything that can be counted counts." What ultimate outcomes do we want? The CDC's framework17 for mental health and suicide prevention recommends promoting "communities where all people experience a sense of hope, connection, purpose, and meaning." What does this look like?
“Communities have hope for the future that is grounded in a sense of identity and unique value.”
“Communities are designed to support a tight knit network of resources and connections between people and to their culture. People feel safe within and connected to their community.”
“Communities create opportunities for individuals to have a sense of purpose in their daily lives.”
“Communities support everyone in having — a sense of how they, their families and cultures are a part of something bigger, however that is defined for them.” (meaning)
Closing and Bridging Challenge
In summary, I have covered the challenges we face, why YOU are needed more NOW than ever, and how the Health Leadership Trivium — learning, healing, and impactful — will supercharge your effectiveness as individuals, teams, and organizations to tackle these challenges.
Finally, I want to leave you with a Bridging Challenge. Amanda Ripley, journalist and author of “High Conflict—Why we get trapped and how we get out,”18 reminds us that any one of us can be swept up into conflicts that can spiral into self-perpetuating, all-consuming states of distrust, polarization, dehumanization, and harm.
In a recent podcast,19 she shared her Appreciative Inquiry mindset for interviewing people whose beliefs and values clash with hers: “I’m not interested in resolving it. I’m also not interested in avoiding it ... My goal, as a journalist and as a human, is if I can do one of three things: Can I, myself, understand the other person, the problem, or myself a little better through this encounter?” She chooses to engage by listening and learning, not debating or persuading. People who feel heard are more likely to listen. She creates space for dialog and building trust.
Here is my Bridging Challenge to you:
In the coming weeks, reach out and get to know someone who does not share your values, or with whom you have a disagreement or misunderstanding. Of course, do this safely. You might even start with a family member. Professor john a. powell calls these “short bridges.” He recommends mastering the short bridges before the long bridges.
Focus on listening, and learning about them, the issue, or yourself. It’s not a debate.
Reflect and act on what you learn.
Repeat steps 1 to 3.
Bridging is the path to building alliances and social connection. Bridging starts with curiosity, inquiry, and learning. Bridging weaves a social fabric that promotes healing, strength, and resilience.
To the Class of 2025, Congratulations again!!!
Go forth and be learning, healing, and impactful public health leaders!
Resources
For learning
For healing
See: UC Berkeley Othering and Belonging Institute
Braver Angels is leading the nation’s largest cross-partisan, volunteer-led movement to bridge the partisan divide and strengthen our democratic republic.
Weave: The Social Fabric Project tackles the problem of broken social trust that has left Americans divided, lonely, and in social gridlock. Weave connects, supports, and invests in local leaders stepping up to weave a new, inclusive social fabric where they live. The project was founded by New York Times columnist and author David Brooks at the Aspen Institute.
For impactful
See California Department of Public Health Strategic Plan 2025-2030
Acknowledgments
HUGE shout out to Dean Cheryl Anderson (left)! She is a superstar dean that is beloved by the students, staff, and faculty. UCSD HWSPH is only 5 years old and she steered them through the difficulties of launching a new school during the COVID-19 pandemic. She models the leadership attributes I promoted in my address and much more!
Footnotes
Governmental public health is unique because we represent everyone in our jurisdiction and we practice within a political structure. As public health practitioners we should always start with inquiry before advocacy, and curiosity before certainty.
Tierney, Stephen. Leadership: Being, Knowing, Doing. 1st ed. London: John Catt Educational, Limited, 2022 (book).
Yuval Noah Harari (2024). Disruption, Democracy and the Global Order – Yuval Noah Harari at the University of Cambridge (YouTube).
Harari, Yuval Noaḥ. Nexus: A Brief History of Information Networks from the Stone Age to AI. First edition. New York: Random House, 2024. https://www.ynharari.com/book/nexus/. (book)
Trust for America’s Health. “Pain in the Nation 2025: The Epidemics of Alcohol, Drug, and Suicide Deaths.” Trust for America’s Health, May 28, 2025. https://www.tfah.org/report-details/pain-in-the-nation-2025/.
Definition adapted from Intellectual Humility (webpage).
Stavros, Jackie, and Cheri Torres. Conversations Worth Having: Using Appreciative Inquiry to Fuel Productive and Meaningful Engagement. Second edition. Oakland, CA: Berrett-Koehler Publishers, Inc, 2022 (book). https://www.conversationsworthhaving.today/store#section-1674342743697.
California Department of Public Health
Source: Kemia Sharraf, Lodestar Consulting and Executive Coaching, https://www.lodestarpc.com/dr-k.
powell, john a, and Stephen Menendian. Belonging without Othering: How We Save Ourselves and the World. Stanford (Calif.): Stanford University press, 2024. (book)
powell, john a., and Rachelle Galloway-Popotas. The Power of Bridging: How to Build a World Where We All Belong. Louisville: Sounds True, 2025. (book)
John Dickson (2011). WCA Summit Sunday - John Dickson - Humilitas (YouTube). This is an inspiring talk on humility.
Amanda Ripley. High Conflict: Why We Get Trapped and How We Get Out. Simon & Schuster, 2022. https://www.simonandschuster.com/books/High-Conflict/Amanda-Ripley/9781982128579.
The Atlantic Podcast (2023), featuring Amanda Ripley. How to Have a Healthy Argument (YouTube).
What an inspiring speech! I feel blessed and honored to have had the opportunity to work for your organization under your leadership! - Amanda
Inspiring words! Let’s do this!