Leana Wen: Geography should not be destiny

Baltimore's new health commissioner begins her work Thursday and is inspired by public policies that transform

Tomorrow, I begin serving in Mayor Rawlings-Blake's administration as the Health Commissioner of Baltimore City.

"Where did you go to school?" many have asked. I don't come from Baltimore, so I want to explain why I'm here by sharing where I come from. My parents and I immigrated from China when I was 8. I grew up in inner-city Los Angeles, including Compton and East L.A. My classmates were victims and perpetrators of gun violence; our friends and neighbors suffered from drug and alcohol addiction; and I saw what happens when people do not have access to health care and die from treatable problems related to poverty and disparities.

Those experiences motivated me to become a physician. I wanted to be an emergency physician because I never wanted to turn any patient away. But it's from working in the ER that I saw the limitations of medical interventions. We can resuscitate teenagers who are shot and stabbed, revive victims of drug overdoses and treat complications from diabetes and heart disease. These are important life-saving measures, but they also demonstrate why we also need upstream interventions like safe schools, violence prevention and preventive health.

This is what led me to become a community organizer in L.A. and St. Louis, Mo., then a public health professor in Washington, D.C. I sought to go beyond addressing sick care to stopping disease before it starts. My passion is to tackle unjust health disparities; my goal is to change the unfortunate reality that geography is often destiny.

I am inspired by innovative public policies that transform health. In San Francisco, Dr. Mitch Katz showed how critical safe housing is to good health; in New York City, Dr. Thomas Frieden effected policies like banning smoking in bars and artery-clogging fats in restaurants to encourage healthy lifestyles and reduce chronic disease.

Right here in Baltimore, at the helm of the longest continuously-serving public health agency in the country, former Health Commissioner Dr. Peter Beilenson pioneered widely-emulated programs such as harm reduction through needle exchange and lead abatement to produce healthy homes. Dr. Josh Sharfstein expanded access to drug treatment through the Baltimore Buprenorphine Initiative and fostered the development of the city's infant mortality strategy. His successor and my predecessor, Dr. Oxiris Barbot, developed a blueprint for health in Healthy Baltimore 2015.

I am incredibly excited to work for a visionary leader who so clearly understands how health ties into all social policies. Mayor Stephanie Rawlings-Blake has proven that she will take bold steps at reform by addressing big problems with big solutions. Attacking the root causes of disparities is far from easy, but I am optimistic. In my short time in Baltimore so far, I have seen the dedication of so many who are devoted to transforming the health of the city. Not least is the superb team of the more than 1,100 health department employees I am proud to join.

In the next 100 days, I plan to launch three interdisciplinary campaigns to focus on three critical issues: youth wellness, substance abuse and population health. Specifically, I plan to:

•Support youth in achieving their highest potential by accelerating efforts to address asthma and vision health, improve school readiness and reduce youth violence;

•Tackle the epidemic of substance abuse by building public and private partnerships to prevent overdose deaths and expand access to integrated behavioral health services;

•And improve health care systems for vulnerable populations by working with community and medical groups on innovative solutions.

As I dive in, I will reach out to community members so that I understand their biggest concerns and their perspective on how best to address them. I am starting a "listening tour" with community activists, religious leaders, hospitals, federally qualified health centers, universities, foundations and business coalitions, and I will also be volunteering in local ERs and clinics to understand our patients' health needs first hand. And I am dedicated to learning about all the amazing work already been done in Baltimore and how our health department can facilitate public-private and multi-sector collaborations.

Monday is Martin Luther King Day, a holiday honoring a tremendous leader who stated, "Of all the forms of inequality, injustice in health care is the most shocking and most inhumane." What drives me every day is my background and where I come from. I am excited and honored to join Mayor Rawlings-Blake and the citizens of Baltimore to fight for health equity and social justice.

Dr. Leana Wen begins her service as the Baltimore City Health Commissioner today. Her email is health.commissioner@baltimorecity.gov. Twitter: @DrLeanaWen and @BMore_Healthy.

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