The need for innovation in governmental public health practice is clear. There continue to be emerging and recurring public and population health threats that require both rapid response and the infrastructure to support this response, as illustrated with the opioid epidemic, measles outbreaks, and the increase in number and type of natural disasters. There are also growing resources being directed towards addressing the social, economic, and physical conditions and environments, as these significantly impact the health and wellbeing of people living and working in the community. Our traditional ways of addressing these issues, through single streams of funding, waterfall implementation approaches, siloed efforts, and remedial solutions, coupled with growing disparities and inequities and increasing public health needs within communities, are not sufficient or efficient – we need new ways of addressing immediate and longer-term public health priorities. Given the complexity of these population health issues, there is an increasing emphasis on the importance of working together, both across sectors and with community voice, to make lasting and transformative improvements in health. As the field looks to improve population health through transformation of the public health system, innovative health departments are working to engage strategic partners, authentically engage communities, and serve as a strong backbone to the larger public health system for collective action.¹

Three years ago, PHNCI set out to define public health innovation to inspire and guide the field towards transformational public health practice to more effectively address the issues communities and public health departments are facing described above. The initial definition, developed in 2017 with support from experts in public health and in the innovation space, provided direction to communities to differentiate between important public health work happening every day and areas where innovation has the potential to transform practice and the community. Aligning with innovation principles, the initial definition was meant to be a prototype, and was released to the field to test through their emerging practices. During the last three years, PHNCI has been learning, sharing, strategizing, and co-producing with communities in practice areas that align with the initial definition, such as health equity, data collection and analytics, health in all policies, systems redesign, and access to services. We have learned:

• What is unique to innovation versus more traditional efforts;
• That communities are introducing innovations every day;
• How public health is creating the infrastructure and systems to support a culture of innovation; and
• We still have much to learn!

What we do know is that innovation processes and mindsets can be a powerful tool in transforming public health practice to address complex problems and to grow its role in working with partners and the community to improve population health and equity. Innovation allows novel responses to unmet public health needs by creating new ways practices that can improve efficiency, effectiveness, and quality. Given this and the array of lessons learned to date and the evolution of the field during that time, we revisited and updated the definition to reflect these learnings and to streamline the definition to its necessary components. In addition to our learnings, the revised definition also takes into account feedback solicited from attendees of PHNCI’s first annual Public Health Innovation Summit & Showcase in March 2019. The updated, draft definition is:

Definition: Public health innovation refers to the development and/or implementation of a novel process, policy, product, or program leading to improvements that impact health and equity.

Tenets of public health innovation include the following:

• It is an iterative process – not an end point – that can be done incrementally or radically.
• It requires both collaboration (with diverse and relevant team members and partners) and co-production (with the people with lived experience who will be affected by the results of the innovation)
• It is an emerging practice that impacts the status quo and creates value in a way that lends itself to adaptation or replication by others.

While this refreshed definition is not drastically different from the initial one, there are a few key updates we want to highlight: we added the deliberate focus on equity; eliminated characteristics that were focused on the process of innovation versus definitional in nature; and adjusted terms to ensure the precise meaning is conveyed. The goal of this definition is to give meaning to what can otherwise be considered a buzzword, so that communities can use it to drive innovations within their organizations, to understand where their work falls within innovation, to begin conversations with leadership, staff, and communities about transformational public health, and to take the steps to transform the public health system to achieve population health and equity.

Our next step is to get your feedback – what do you think of this definition? Take the short survey below to provide your candid feedback! Additionally, PHNCI continues to ascribe meaning to this work by both supporting innovative projects and disseminating stories about innovative practices that allows for replication.

• What do you think of this refreshed definition? We want to hear from you! Please give us your feedback through this short survey by July 26th.
• Do you have an innovation to share that aligns with this definition? Submit yours today!

¹ US Department of Health and Human Services. Public Health 3.0: A Call to Action to Create a 21st Century Public Health Infrastructure. www.healthypeople.gov/sites/default/files/Public-Health-3.0-White-Paper.pdf. Accessed June 27, 2019.