Baltimore has been blessed with a series of superstar health commissioners, and Dr. Leana Wen is no exception. She combined an emergency room physician’s sense of urgency with the intense focus on Baltimore’s deep seated health problems and the boldness in addressing them that have been hallmarks of the department. It’s no fluke that the National Association of County and City Health Officials named it the top big health department in the country this year. We are sad, if not altogether surprised, to see that Dr. Wen has been recruited away for a national post, and we have every expectation that she will be just as successful in running Planned Parenthood as she has been here.
Now Mayor Catherine Pugh faces the task of finding a new head for what may be Baltimore’s most functional department at the same time that she’s seeking a new leader for what’s arguably its most troubled. But she should consider the search for a new health commissioner to be as crucial to the city’s future as the search for a new police commissioner. Just as many lives — if not more — are on the line. That’s true of the overdose epidemic alone, which claims twice as many lives per year in Baltimore as homicides — but also when it comes to broader health disparities that lead to a two-decade difference in life expectancy from one city neighborhood to another. Baltimore’s health department has a unique track record of innovation, effectiveness and public support that should enable the city to once again recruit a visionary leader. We can’t let that opportunity go to waste.
Baltimore’s health department excels at the bread and butter work of public health — for example, its highly successful intervention to reduce infant mortality through mutli-faceted interventions in the lives of pregnant women and new mothers. But it has also long been willing to push the envelope with politically risky but methodologically sound interventions, like the free needle exchange Baltimore created two decades ago to reduce disease transmission among intravenous drug users or the blanket prescription for the anti-overdose drug Narcan that Dr. Wen issued. We need another leader who is unafraid to analyze health problems with an open mind, go where the data leads, and advocate for the most effective interventions in the public and among elected leaders.
We also need a commissioner who isn’t shy about seeing the department’s mandate expansively. Baltimore’s health department has the analytical expertise, the institutional habit of looking at old problems in new ways, and the programmatic experience to help in a wide variety of areas. Baltimore’s zoning code update a few years ago might have seemed outside the health department’s lane, but Dr. Wen’s predecessor, Dr. Oxiris Barbot, made a strong public health case for changes to limit the number of liquor stores in residential neighborhoods. Similarly, the struggles of students in the classroom may seem outside of the department’s purview, but Dr. Wen, in partnership with Johns Hopkins University, was nonetheless able to make a tremendous difference in the Baltimore school system by arranging in-school eye exams and free glasses. Under her leadership, the department went further than a public health traditionalist might in terms of pulling hospitals into the opioid epidemic fight, but it was necessary — and largely welcomed here.
The next health commissioner could pull the agency further into the effort to break Baltimore’s cycle of violence — after all, killings and retaliation here operate in much the same way as an infectious disease. Great opportunities also exist in focusing on at-risk adolescents to prevent teen pregnancy, drug use, chronic absenteeism and other behaviors that can make the difference in their lives. The question in Baltimore has not been and should never by why the health department is getting involved in a particular issue. Rather, we should be asking why it isn’t.
From asthma to addiction to obesity to lead poisoning, Baltimore presents innumerable challenges for its health officer — but it also has a highly effective health department, a ready source of expertise and new recruits from the state's top-tier public health schools, and prime access to policymakers in Washington. This is a job that should attract the most ambitious, innovative public health professionals in the country, and that’s exactly who Mayor Pugh should be looking for.