Shift Organizational Culture

How public health departments can transform their culture to be more inclusive, responsive and accountable to staff and communities

Health departments, like other government bureaucracies, often have organizational cultures that reflect the dominant status quo that upholds white supremacist, heteropatriarchal, and capitalist values. This dominant culture impedes health departments’ efforts to advance health equity and racial justice. The famous quote “culture eats strategy for breakfast” holds true — the best laid plans and strategies for health equity and racial justice will fall short without a shift in organizational culture.

Organizational culture is shaped by the underlying set of beliefs, attitudes, systems, and rules that structure institutions and internalized ideas about what it means to be “professional” at work. Thus, to shift culture, health departments have to create space and practices for staff that shift mindsets, attitudes, and systems towards collective, relational, heart-centered spaces. In the context of government and its bureaucracies, this shift can be deeply counter-cultural.

Culture is not just how people and organizations do work together, but how they practice ‘being’ together. To shift organizational culture towards equity and justice, public health practitioners need to regularly return to their container for equity work, finding ways to maintain, deepen and expand it. Central to this shift is integrating the head and heart. Analysis alone will not suffice to create a just society — transformative work also requires attention to the emotional and physical ways people react and self-regulate in the work. Public health practitioners and health departments need to challenge the tendency to suppress the shared pain and trauma of living through, witnessing, or perpetuating systems of oppression. By integrating the head and the heart, health departments can break down this false dichotomy between thinking and feeling.

Action Steps health departments can take to shift organizational culture:

• Practice small ways to shift how you meet and work together, like sharing pronouns and other identities beyond job titles in meeting introductions — as adrienne marie brown says, “what we practice at the small scale sets the pattern for the whole system”
• Integrate heart-centered practices to create space for staff to slow down and notice any emotions that might be impacting their ability to show up as their full selves (e.g. Window of Tolerance check-ins and sharing access needs before meetings)
• Use art, music, food, film and the strategies of cultural organizing to enliven and actively shift the culture and feel of working at your organization
• Nourish your relationships at work, with partners, and in community, noticing where relationships are defined by coercive or extractive “power-over” dynamics and shifting towards emphasizing mutually beneficial relationships shaped by sharing “power-with”
• Build and deepen accountable relationships with community organizations and encourage your colleagues to build relationships too
• Focus on those who are interested in shifting culture together toward equity and justice; don’t get stuck in unstrategic battles and opposition with people who are opposed or resistant