Honoring Lloyd Novick’s Legacy in Advancing Public Policy Expertise

Introduction: Lloyd Novick and the Power of Policy Public health practitioners often think of policy as "Big P"—legislation, regulations, or major funding decisions that shape the national health landscape. However, public health practice also relies heavily on "small p" policy: the organizational guidelines, administrative procedures, and community-level rules that determine how health departments operate on a day-to-day basis.1,2 Lloyd Novick understood this duality intuitively. As the longtime editor-in-chief of the Journal of Public Health Management and Practice (JPHMP), he built one of the nation's most important platforms for exploring the roles of both Big P and small p policy in public health—and for nurturing the next generation of practitioners who would use policy to improve population health. Lloyd's recent passing offers an opportunity to reflect on the remarkable legacy he leaves behind: a journal, a community, and a body of work that elevated policy expertise from a peripheral skill to a core competency for public health leaders. Small p Policy: Why It Matters Small p policies—internal, organizational, and community-level rules and guidelines—are often invisible to the public but crucial to the functioning of health departments. They define how funding is deployed, how quickly a department can hire staff, how flexibly it can respond to an emergency, and how equitably public health serves its population. Lloyd saw that small p policies, when thoughtfully designed, could improve performance as much as statutory changes. Through editorials, special issues, and invited commentaries, the JPHMP, under Lloyd's leadership, became a clearinghouse for studies and commentaries that analyzed and improved these operational policies. He encouraged case studies that demonstrated how internal rules about data sharing, budgeting, or quality improvement could either enable or impede population health goals. The Interplay of Big P and Small p Policy Lloyd also highlighted how small p policy and Big P policy intersect. Federal or state legislation may man-date a new program, but it is the local policy infra-structure that determines whether it is implemented effectively. Lloyd promoted the policy practice of scores of authors, including the authors of this paper. In the case of one of the authors (JA)—from HIV policy reform as a state AIDS director,3 to emergency preparedness post-9/11 as a city commissioner,4 to efforts at CDC and Trust for America's Health to address social determinants of health5—the JPHMP provided a venue where those intersections could be examined and lessons shared. In the case of the other author (RCB)—the JPHMP was a critical place for describing core elements of small p policies that shape evidence-based decision making in public health agencies,6 assessing the determinants and impacts of agency accreditation,7,8 and formalizing the elements and reach of health equity in public health practice.9 Impacts on Small p Policy Lloyd's impact on public health policy can be grouped into several broad "buckets," each reflecting his deep commitment to improving practice through evidence, education, and connection. Leadership in State, Local, and National Public Health: Lloyd served with distinction as a state health commissioner and a local health official. He chaired task forces that shaped national thinking about preparedness, chronic disease prevention, and workforce development. It was perhaps this experience that made him greatly value the voices of practitioners on the front line—those working every day at the local, state, tribal, territorial, and federal levels. Building the Evidence Base for Small p Policy: Through the JPHMP, Lloyd curated and elevated articles that built a shared knowledge base for management and policy decisions. His edited volume, the JPHMP's 21 Public Health Case Studies on Policy and Administration, remains a teaching tool for students and a resource for practitioners. Strengthening Academic-Practice Linkages: Lloyd highlighted the work of academics who evaluated and analyzed the practices that improved health and/or failed to do so—looking at the impact on cost as well as on health and well-being. He used the Journal to demonstrate not only what interventions were evidence-based but also how they could be implemented feasibly and within a realistic timeline. As the Chair of the Council of Linkages between Academia and Public Health Practice, he spearheaded the development of evidence-based guidelines for population-based prevention,10,11 fostering collaboration between academic research and public health implementation. Curricular Innovation: Recognizing that tomorrow's practitioners must understand public health policy, Lloyd worked to infuse public health content into medical curricula and those of other professions. He edited the textbook Public Health Administration: Principles for Population-Based Management,12 which, repeatedly updated and widely used, became a standard reference for students learning the management and policy context of public health. Voices from the Field: Lloyd recognized that it was not easy for frontline practitioners to find the time to write for (and jump through the hoops of) journals. So, he streamlined and simplified the process whenever he could so their voices might be heard. If an author from a health department had a lesson to impart, he tried to remove barriers that might discourage them from writing and slow the dissemination of valuable information. There were both formal and informal ways of submitting pieces to the Journal. If Lloyd saw the value in a local or state practitioner's experience, he greased the wheels to make it happen. Last year, when he received a short description of the impressive work of Kina White in the Mississippi Department of Health that focused on expanding the practice of age-friendly public health (ie, attention to the overall health of older adults),13 he said this was just the type of article the Journal should publish and okayed it on the spot. Those who collaborated with Lloyd will remember his warmth, generosity, and humility when considering articles for the Journal or offering insightful guidance to countless practitioners. Despite his many accomplishments, Lloyd listened carefully, encouraged collaboration, and celebrated the successes of others more than his own. A Legacy That Lives On Lloyd Novick transformed the JPHMP into a hub where policy—both Big P and small p—is debated, refined, and translated into action. His influence will continue to shape public health through the many professionals he mentored and the rich editorial record he leaves behind. For those of us who had the privilege of knowing him, Lloyd's passing is a personal loss. But it is also an invitation to carry his mission forward: to make policy expertise a core public health skill, to strengthen the links between academia and practice, to advance health equity through both organizational and legislative change, and to support the next generation of practitioners with the same kindness and clarity he showed us.