Route Notes

In this episode of Route Notes, Wes and David reflect on inclusion, access, and the quiet power of systems designed with care. From a joyful moment of off-road driving with Wes’s newly licensed daughter to a breakthrough theater performance by David’s son Miles, they explore how moments of belonging—when thoughtfully created—can reshape lives and communities. They unpack the concept of universal design, tracing its implications from curb cuts and classroom accessibility to larger conversations about structural harm and structural grace. Along the way, David shares the remarkable public health story of how replacing coal gas with natural gas in mid-century Britain unexpectedly reduced suicide rates by one-third—an example of how systems can heal. This wide-ranging conversation weaves together personal stories, policy insights, and a compelling call to design for dignity—creating spaces where everyone can show up fully, thrive, and be heard.

In this episode of Route Notes, Wes and David explore what happens when leaders overshare, overprocess, or unravel in public—and the unintended consequences it can have on teams, trust, and momentum. A strange moment on a delayed flight (where the pilot shares a little too much about what went wrong) widens into deeper reflections on leadership and the tension between authenticity and stability. They recount one of their most bizarre and hilarious facilitations where the cost of oversharing in leadership moved past vulnerability into volatility.  Plus: David’s detour through Manhattan’s High Line and a Swiftie-approved backup plan for those staying grounded.

In this month’s Campfire Chat, Wes, David, and Adam gather fireside to discuss Faith-Rooted Organizing by Alexia Salvatierra and Peter Heltzel. What begins as a reflection on the role of churches in public health quickly deepens into a powerful conversation about moral imagination, structural injustice, and the difference between acting out of anger versus love. The episode dives into real stories of immigration reform, labor advocacy, and interfaith collaboration—each grounded in deep compassion rather than political expediency. They wrestle with how these lessons apply to their own work in public health and community partnerships, especially in regions like the rural South. Along the way, they explore the limitations of technical planning, the importance of trust-building, and why prayer—often dismissed as “soft”—can be one of the most radical acts of solidarity. Plus: a detour worth taking into the novels of Lisa Wingate, and a sneak peek at next month’s pick, Under the Sky We Make by Kimberly Nicholas.

In this episode of Route Notes, Wes and David debrief after a jam-packed weekend of community service and public health engagement. David shares the chaos and clarity that came from trying to over-engineer a complex event serving children with intellectual disabilities—only to have the day go off the rails and then somehow soar thanks to the brilliance of students, staff, and volunteers. Wes and David reflect on the danger of linear thinking in complex environments, the difference between systems like Chick-fil-A and community-based work, and the power of trusting your team and centering mission over meticulous plans. Along the way, they offer lessons for leaders, educators, and planners—plus a detour about hot peppers and poor choices. This one’s about humility, flexibility, and the incredible outcomes that emerge when people show up, lean in, and care deeply.

In this episode of Route Notes, David and Wes unpack the future of public health education against the backdrop of Campbell Cares Community Days—service-based learning grounded in interprofessional collaboration. They dive into the tension between machine-driven public health and the human-centered practice that's urgently needed, arguing that the curriculum of the future must move beyond technical training toward embedded community relationships, ethics, and real-time apprenticeship. The episode explores real examples of students doing windshield surveys with tribal partners, running health fairs in unexpected places, and hosting deeply personal talking circles with survivors of violence. Along the way, they discuss the role of AI, the dangers of replacing lived experience with simulation, and why "fixing problems you can touch with people you know" might be the most important learning outcome of all.

In this episode of Route Notes, Dr. David Tillman responds directly to recent statements by political leaders, including RFK Jr. and Donald Trump, about autism rates and causes. Drawing from his experience as a public health professor, researcher, and father of a son with autism, David walks listeners through the science behind rising autism diagnoses—explaining what has changed in diagnostic criteria, awareness, and demographic risk factors. He breaks down why the one-in-10,000 claim is misleading, what large-scale studies like CHARGE have actually found, and how the vaccine-autism myth took root from a now-discredited study. With clarity and compassion, this episode challenges misinformation while championing evidence-based research and greater inclusion for individuals with autism.

What do birds, highways, coffee, camping, and peanut butter & jelly have in common? In this unexpected and wide-ranging conversation, David and Wes unpack the viral TikTok moment that sparked a deeper dialogue about structural racism, public health, and the power of storytelling. Together, they reflect on how these layered stories shape opportunity, health outcomes, and cultural participation across generations. Along the way, they discuss implicit bias, rural health, medical education, marketing, and the subtle power of association—what peanut butter and jelly can teach us about racism. 

In this episode of Route Notes, we explore the power—and necessity—of the U-turn. What happens when leaders, communities, or even parents choose to pause, reflect, and reroute? Wes shares a personal parenting moment that sparked the episode, along with a hilarious cautionary tale involving an overconfident Eagle Scout, an underprepared hike, and a poorly chosen shortcut. Along the way, we reflect on what it means to admit a mistake in public health and leadership without losing trust. Spoiler: Done well, it can actually strengthen it. If you've ever barreled ahead only to realize you're off-course—this one’s for you.

In this episode of Route Notes, we dive into Moral Ambition by Rutger Bregman—a book that asks a direct and timely question: what are you doing with your life, and why not work on something that matters? Inspired by the energy of a new academic year, we reflect on what it means to channel ambition toward meaningful change, especially in public health and community work. The conversation ranges from tech-driven distraction to the joy of deep purpose, from purity politics to the unexpected ways people show up for change in their everyday lives. We talk about noble losers, idealism without action, and why real progress often depends not just on inspiration but on tactical, resilient work behind the scenes. Whether you're just getting started or looking to reconnect with the “why” behind your work, this episode is a challenge to step in—and step up. Next up: Faith-Rooted Organizing by Alexia Salvatierra. Join us for the next Campfire Chat as we explore how faith communities can be mobilized toward justice and transformation.

In this episode of Route Notes, we explore how constraints—those limits we often try to eliminate—can actually fuel creativity, collaboration, and community. From policy and innovation to loneliness and shared norms, we reflect on what gets lost when we remove the very boundaries that once held us together. We talk about the unintended consequences of convenience, the erosion of social connection, and why policymaking might benefit from asking one simple question: what good might this constraint be doing? Whether it’s the shift to telemedicine, the decline of shared public spaces, or the overwhelming paradox of choice, this episode invites listeners to think differently about what holds us back—and what might be holding us together.

In this episode of Route Notes, we’re joined by Dr. Michael Forde—public health leader, equity strategist, and master storyteller—for a conversation about what really drives change in health and healthcare. From his current work in health equity to his experience at the NIH during the height of the COVID-19 pandemic, Dr. Forde shares what he's learned about trust, empathy, and the stories that stay with us. We explore how storytelling isn't just a tool—it's a core skill for public health, strategic planning, and systems change. This conversation moves from personal experience to national policy, from implicit bias in healthcare settings to the hopeful power of cultural humility and connection. If you've ever felt the gap between the data and the humans behind it, this one's for you.

In this episode of Route Notes, we reflect on the central role of story in planning, leadership, and decision-making. Over years of working with organizations and communities, we’ve found that strategy doesn’t emerge from filling in templates—it emerges from narrative. We talk about what changed in our own facilitation approach, including the moment we stopped asking people to start with templates and instead invited them to tell a story.  This is an episode about how humans are wired for meaning, not metrics—and how facilitators, leaders, and strategists can harness the power of story to unlock clarity, alignment, and momentum.

In this episode of Campfire Chat, we dig into Abundance by Ezra Klein and Derek Thompson, a bold call to rethink how we approach public policy, innovation, and problem-solving. Framed around a powerful question—what if we planned for abundance instead of assuming scarcity?—this conversation explores the real potential of government-driven innovation, from Operation Warp Speed to climate tech, housing reform, and scientific research. We discuss the book’s techno-optimism, the role of crisis in mobilizing action, and why some of our biggest wins—like the COVID-19 vaccine rollout—became political orphans. We also wrestle with the deeper tradeoffs, like red tape and risk aversion, that slow down real progress. Along the way, we reflect on what this framework could mean for universities, health departments, and anyone leading through complexity. Spoiler: it starts with being willing to change. Want to read along for next time? We’ll be tackling Moral Ambition by Rutger Bregman in the next Campfire Chat. Grab a copy and join the conversation.

You’ve heard the phrase. You’ve probably said it: “Let’s not reinvent the wheel.” But what if that mindset is keeping us from real solutions? In this episode, Wes and David take a hard look at the cliché—and argue that relying too heavily on other people’s answers can actually short-circuit innovation, especially in rural communities and complex systems. They unpack: Why “not reinventing the wheel” can be lazy leadership The dangers of assuming sameness in community solutions How starting from scratch invites creativity, ownership, and context Why borrowing policies and plans can erode public trust The power of starting with a blank sheet and local wisdom This one’s for the leaders who are tired of copy-paste planning and want to build strategies that actually fit their communities.

In this first installment of a recurring series - Campfire Chat, we gather around the fire to explore Jonathan Haidt’s The Righteous Mind: Why Good People Are Divided by Politics and Religion. Through conversation that weaves together moral psychology, public health, theology, and community engagement, we reflect on what Haidt’s work can teach us about polarization and the limits of reason. We discuss how moral intuitions often drive human behavior more than evidence or logic—and what that means for professionals working in divided communities. Drawing on real-world examples from public health practice and education, we consider how relationships, trust, and shared values might offer a better path toward understanding and collaboration. This episode also touches on broader questions of relevance facing both the church and higher education, and the importance of reimagining connection in a fragmented world.

What do Jurassic Park, public health, and artificial intelligence have in common? More than you'd think. In this episode, David and Wes take a detour into the ILM docuseries Light & Magic and the story of Phil Tippett—the legendary visual effects artist who thought he was rendered obsolete by CGI, only to find himself more valuable than ever. Using this moment in film history as a powerful metaphor, they explore the AI revolution in public health, higher education, and everyday work. What happens when the skills we’ve mastered are no longer needed in their original form? What does it mean to transition from stop-motion expert to strategic guide for the future? If you're a public health professional, educator, or anyone wondering how to stay relevant and human in the age of machines, this one’s for you.

Route Notes is a weekly podcast hosted by David Tillman and Wesley Rich. Each episode dives into leadership, systems thinking, and the messy realities of making change—whether in organizations, communities, or everyday life. Smart, reflective, and occasionally funny on purpose. New episodes weekly on Spotify, iHeartRadio, Apple Podcasts, and YouTube.

What does it mean to see someone—not just treat them? In this episode of Route Notes, Dr. Shaunesse’ Jacobs Plaisimond joins Dr. Wesley Rich and Dr. David Tillman for a powerful conversation on person-centered care, maternal health, and how systems often fail to honor the full humanity of the people they serve. Drawing from her work in religion, ethics, and human rights, Dr. Plaisimond shares why personhood is not a soft concept—it’s the foundation of ethical health practice. From the legacy of exploitation in medicine to the promise of reimagining public health through story, spirituality, and justice, this episode is a moving call to see patients as people, not problems. Healthcare isn’t just about outcomes—it’s about dignity.

What if the public health “magic bullet” isn’t a single program or intervention—but a mindset? In this episode of Route Notes, Dr. David Tillman and Dr. Wesley Rich explore the astonishing 72% reduction in fentanyl-related deaths in Harnett County, NC, and unpack why it didn’t come from doing just one thing. Instead, it came from embracing complexity, honoring local wisdom, and resisting the urge to oversimplify wicked problems. They challenge the iconic upstream/downstream metaphor, share insights from real-world opioid response work, and introduce a new way of thinking: health as a watershed, not a pipeline. If you're tired of linear models that don’t reflect real life—and want to know what happens when a community truly co-creates its own strategy—this episode is for you. Data still matters. But so does trust, tacit knowledge, and making room for every voice.

In this powerful first episode of Route Notes, Dr. David Tillman and Dr. Wesley Rich dive deep into the heart of public health in America—particularly in rural communities—and why this moment matters more than ever. From an unforgettable keynote in Iowa to honest reflections on vaccine hesitancy, polarization, and the overlooked power of relationships, this conversation is a hopeful call to action. Hear why relationship-building—not just data—is the future of public health, how small towns are poised to lead, and why taking people’s questions seriously might be our most effective strategy yet. With humor, humility, and hard-earned insight, David and Wes invite you to reimagine the public part of public health. This is not about selling health—it's about cultivating it.