Bal­ti­more health com­mis­sioner: this ‘was my dream job’

Baltimore Sun - - COMMENTARY - By Leana S. Wen Dr. Leana S. Wen is the in­com­ing pres­i­dent of the Planned Par­ent­hood Fed­er­a­tion of Amer­ica. Twit­ter: @DrLeanaWen.

Ibe­came a doc­tor be­cause I wanted to pro­vide care to those who are the most vul­ner­a­ble. In the ER, I saw how much poverty, race, ZIP code and per­sist­ing dis­par­i­ties in­flu­ence health — that it’s pub­lic health that can level the play­ing field of in­equal­ity.

Four years ago, I was given the in­cred­i­ble op­por­tu­nity to be­come the Bal­ti­more City health com­mis­sioner. It was my dream job. To­day is my last day. Next month, I be­gin my new role as pres­i­dent of Planned Par­ent­hood. Through the lead­er­ship of Mayor Stephanie Rawl­ings-Blake and Mayor Cather­ine Pugh, and with the part­ner­ship of com­mu­nity or­ga­ni­za­tions, faith lead­ers, hos­pi­tals, busi­nesses, uni­ver­si­ties and civic vol­un­teers, we have made sig­nif­i­cant strides to im­prove health and com­bat dis­par­i­ties.

Our B’more for Healthy Ba­bies pro­gram, which en­gages more than 150 pub­lic and pri­vate part­ners, has de­creased in­fant mor­tal­ity by nearly 40 per­cent over the last seven years, closed the dis­par­ity be­tween black and white in­fant mor­tal­ity by morethan 50 per­cent and dropped teen birth rates by 61 per­cent.

We ex­panded the suc­cess of B’More for Healthy Ba­bies into a city­wide youth health and well­ness strat­egy that in­cluded sim­ple but life-chang­ing in­ter­ven­tions — like glasses. With part­ners in­clud­ing Johns Hop­kins Univer­sity and Warby Parker, we started Vi­sion for Bal­ti­more, which is pro­vid­ing eye ex­ams and glasses to ev­ery child who needs them, right in their schools, with­out the child miss­ing class or the par­ents miss­ing work. At its half­way mark ear­lier this year, Vi­sion for Bal­ti­more had dis­trib­uted more than 3,000 pairs of glasses in 81 schools.

In the face of the opi­oid epi­demic, we de­vel­oped an ag­gres­sive and com­pre­hen­sive strat­egy for pre­vent­ing over­dose and treat­ing ad­dic­tion. In 2015, I is­sued a blan­ket pre­scrip­tion for the opi­oid over­dose an­ti­dote nalox­one. Res­i­dents have used nalox­one to save nearly 3,000 lives of fel­low res­i­dents in the last three years. To in­crease ac­cess to “on de­mand” treat­ment, Bal­ti­more opened a first-of-its-kind sta­bi­liza­tion cen­ter — the be­gin­ning of a 24/7 ER for ad­dic­tion and men­tal health. We be­came the first city in the coun­try to work with all 11 hos­pi­tals to im­ple­ment “lev­els of care” best prac­tices for ad­dic­tion treat­ment. To­gether with Be­hav­ioral Health Sys­tems Bal­ti­more and our part­ners in pub­lic safety, we started Law En­force­ment As­sisted Di­ver­sion to pro­vide treat­ment rather than in­car­cer­a­tion and are tar­get­ing “hot spots” to pre­vent deaths from fen­tanyl.

Our agency has strength­ened our core pub­lic health func­tions to pro­tect our res­i­dents by pro­vid­ing best-in-class HIV, STD, hep­ati­tis and tu­ber­cu­lo­sis ser­vices in our clin­ics; pre­par­ing for out­breaks like measles, Ebola and Zika; and pre­vent­ing food-borne ill­ness through en­vi­ron­men­tal in­spec­tions. I’m proud of our in­no­va­tive work to pre­vent falls among older adults, to ex­pand vir­tual su­per­mar­kets and healthy cor­ner stores to re­duce food deserts, and to pi­lot in­no­va­tions such as telemedicine, trauma-in­formed care and the Ac­count­able Health Com­mu­ni­ties pro­gram.

As we work to pro­vide health ser­vices, we have also been on the front­lines of ad­vo­cacy and pol­icy. In the last four years, we have suc­cess­fully cham­pi­oned pub­lic health leg­is­la­tion. Bal­ti­more be­came the first ma­jor city to re­place soda with a healthy drink as the de­fault in kids’ meals. We also banned plas­tic foam con­tain­ers in restau­rants, im­ple­mented a Good Sa­mar­i­tan Lawthat pro­tects peo­ple at an over­dose scene from ar­rest and suc­cess­fully ad­vo­cated for pub­lic health fund­ing for var­i­ous pro­grams in­clud­ing for Healthy Ba­bies, Safe Streets and those that com­bat the opi­oid epi­demic.

We have not been afraid to take on tough fights. When the Trump ad­min­is­tra­tion cut our fund­ing for teen preg­nancy pre­ven­tion ed­u­ca­tion, we sued the U.S. Depart­ment of Health and Hu­man Ser­vices and won, al­low­ing 20,000 young peo­ple to con­tinue to re­ceive ev­i­dence-based ed­u­ca­tion. We also sued the Trump ad­min­is­tra­tion for in­ten­tional and will­ful sab­o­tage of the Af­ford­able Care Act, spoke out against the un­con­scionable cuts to Ti­tle X fam­ily plan­ning grants, and are re­fus­ing to ac­cept in­suf­fi­cient and sig­nif­i­cantly re­duced fed­eral fund­ing for the prob­lems that need ad­dress­ing.

Our team at the Bal­ti­more Health Depart­ment has re­ceived nu­mer­ous recog­ni­tions for our work,. This ex­tra­or­di­nary team does a lot with very lit­tle, and I know that they will con­tinue to de­liver core ser­vices and to fight for health and so­cial jus­tice.

A core prin­ci­ple of pub­lic health is “go where there is the great­est need.” At this time in our his­tory, there is one need that rises above all. I strongly be­lieve the big­gest pub­lic health catas­tro­phe of our time is the threat to women’s health and the health of our most vul­ner­a­ble com­mu­ni­ties. For the last 100 years, no one has done more for women’s health than Planned Par­ent­hood, and that’s where I need to be.

There is much that I have learned from my lead­er­ship in Bal­ti­more that I will take to the work ahead. First, our North Star is our pa­tients and com­mu­ni­ties. We serve ev­ery­one, with a fo­cus on those who are most vul­ner­a­ble. Sec­ond, it’s never an op­tion to say, “it’s not my job” — we do every­thing that we can, be­cause the peo­ple we­ser­ve­nee­dus­now. Third, we do not wa­ver to take on the big fights. Fight­ing for the pub­lic’s health means that we will al­ways be on the right side of his­tory.

Thank you for giv­ing me to profound honor and priv­i­lege of serv­ing as your Bal­ti­more City health com­mis­sioner.

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