Supporting and protecting health in Baltimore

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Dr. Letitia Dzirasa joined Baltimore City government as the Commissioner of Health in March 2019. After training as a pediatrician at Johns Hopkins Hospital, Dr. Dzirasa worked as Medical Director for school-based health and quality at Baltimore Medical System, and at a digital services firm as Health Innovation Officer.  Dr. Dzirasa’s special interests include obesity management and prevention, trauma informed care in children and adolescents, and the expanded use of technology to improve health outcomes.

To mark International Child Health Day, we asked Dr. Dzirasa about her career in public health, and how her background in pediatrics and health technology influences her approach to her new role.

Tell us about why you first got involved in public health.

I first got involved in public health as a medical student. I volunteered at local health fairs put on by fellow students at my medical school, Meharry Medical College. Though we were students, we took our responsibility to serve our community very seriously and took blood pressures as well as provided education to local residents. 

You are not new to Baltimore. As someone who has lived in this city for many years, what does it mean to you to be the city's new Commissioner for Health?

It means a lot to be entrusted with the health of city residents in the city I've called home for more than eight years.  The work of public service is more than a job to me, it's truly a calling.  I'm honored to be able to serve my fellow residents.

You're a trained pediatrician - how does that influence your approach to your new role? 

I think at its core, pediatrics is focused on disease prevention and promoting health. As a pediatrician, so much of what I do is counseling and teaching to promote healthy behaviors and prevent chronic diseases. As a public health professional, my approach is similar – I work with my team to provide education, promote health, and advocate for legislation that supports and protects health. 

You have a background in health IT systems - how will you technology in new ways to help improve population health outcomes?

I'm excited about shifting the department toward being data-driven and community-informed in the decisions we make about our programming. We must use data and look at our clinical outcomes to determine areas of continued need, and to share where we've been successful in positively impacting clinical outcomes. 

Are there other cities in the US that have led on an issue you care about?  Tell us about what you took from that.

I'm really impressed by the work Geisenger Health in Pennsylvania is doing around their Fresh Food Pharmacy.  Food insecurity is such a huge issue nationally, as well as here in Baltimore, and we know the direct linkage between diet and chronic disease development or worsening. We have to begin thinking about how to address people's needs for healthy food options and other social determinants of health in innovative ways.  

A Winning Goal: Pay Equity In Public Health

The US women’s national soccer team’s triumph at this year’s World Cup was about so much more than a game. Their success brought attention to the issue of pay equity, and challenged all Americans to have a real conversation about gender and pay inequity. While the public health field is deeply rooted in social justice and racial, ethnic, and gender equality, there are significant leadership and pay gaps between men and women, despite the fact that much of the overall workforce is female.

Innovating to Reduce Harm in Las Vegas

The costs of the opioid crisis are a top concern among policymakers in Washington, DC, and continue to dominate headlines daily. The cost in human life, family suffering and finances is sobering. In 2017, the nation lost more than 47,000 Americans to opioids, and in my home state, Nevada Department of Health and Human Services Office of Analytics reports that there were 401 opioid-related overdose deaths. This week, a new study estimated that the federal tax revenue lost to the opioid epidemic totals $26 billion, nationally. Diseases related to drug use have also surged, with Hepatitis C increasing 133 percent between 2004 and 2014, tracking with the growth of opioid injection hospital admissions. Reports of dangerous, dirty needles littering public parks and neighborhoods are common.

A Standardized Approach is Needed to Address Social Determinants of Health

By Dr. Colleen Bridger, MPH, PhD.
Director
San Antonio Metropolitan Health District

America leads the world in medical research and medical care and for all we spend on health care, we should be the healthiest people on earth. Yet on some of the most important indicators, like how long we live, we’re not even in the top 25, behind countries like Bosnia and Jordan. There is growing recognition that health starts – long before illness – in our homes, schools and jobs. In fact, only about 20 percent of a person’s health happens in the doctor’s office – the rest happens out in the world and things like healthy air and water may not be in a person’s control.

Now is the Time to Tell Policymakers that Trauma Matters to Our Health

By Kelly Colopy, MPP, BCHC Chair and Director, Long Beach Health Department Director
and
Amanda Merck, MPH, Senior Research Area Specialist, Salud America!, UT Health San Antonio  

Public health professionals all over the country are leveraging practice and policy strategies to address the issue of trauma, including incorporating a “trauma-informed” point of view into the way they conduct business. In recent years, public health science and practice has become more cognizant of the evidence of, and action needed, to support those who suffer from trauma. This awareness and response is starting to transform the field.

Wrapping Up the Highs and Lows of Urban Public Health in 2018

By Chrissie Juliano, Director, Big Cities Health Coalition

As 2018 winds down, I am celebrating my four year anniversary with the Big Cities Health Coalition, which has been a leader in the urban public health field for 16 years. While our membership, staffing, location, and infrastructure have changed over the years, our mission, vision, and goals remain the same: to protect health of those who live in America’s big cities for present and future generations.

Guarding against viral misinformation this flu season

By Joseph P. Iser, MD, DrPH, MSc
Chief Health Officer
Southern Nevada Health District

As a clinician and a public health professional, I see every day how technology can help providers give patients useful information, better care, and drive better outcomes. As doctors, we use online toolkits to help treat our patients, eReferrals to provide more efficient access to smoking cessation resources, and electronic health records can make everything more accessible for both providers and patients. In my role as the Chief Health Officer of the Southern Nevada Health District, I’ve also come to see what a valuable public health tool technology and social media can be. In our agency, we use Twitter, Facebook, and YouTube throughout the year to educate and motivate our community on public health issues from violence, to STDs, and of course, the flu. We created a new video earlier this year about the importance of the flu vaccine and have a Twitter account dedicated to information about the flu.

World AIDS Day 2018: Progress Continues, Disparities Remain

By Kim Rodgers, Communications Specialist, National Association of County and City Health Officials

World AIDS Day, observed annually on December 1, provides the opportunity to highlight our accomplishments, remember those who have lost their lives to HIV and AIDS, and refocus our efforts on what still needs to be done to end the epidemic. Local health departments are in the forefront of these efforts, working on initiatives to address the prevention and treatment of HIV and AIDS and support work towards a cure.

Child Development-Community Policing: How One Local Health Department Joins Local Police on The Front Line in The War on ACEs

By Stacey Butler, LCSW, Child Development-Community Policing Director
and Gibbie Harris, Director
Mecklenburg County Public Health

Gunshots ring out at a Charlotte, North Carolina apartment complex, and a five-year-old girl is struck in the leg by a stray bullet. Charlotte-Mecklenburg Police (CMPD) arrive on scene.  Recognizing the potential psychological trauma for the child and her family, they call the Child Development-Community Policing (CD-CP) on-call clinician. She responds within minutes, providing acute trauma intervention alongside her officer partner, who is beginning the work of helping the child and her family feel safe again. This officer-clinician team continues to visit the family over the next few days and weeks to assess progress and needs, providing targeted interventions, and helping reestablish a sense of safety both inside and outside their home.

Ten lessons we learned about how to deploy teams into post-hurricane settings

By Mitch Stripling, MPA, Assistant Commissioner, Bureau of Agency Preparedness and Response; Colin Stimmler, MA, Senior Director for Agency Preparedness and Response at the New York City Department of Health and Mental Hygiene

Disasters like Hurricane Michael show how severe the public health impacts from a coastal storm can be.  When disasters like this strike, many local and state health workers are often willing to help in another jurisdiction, but they aren’t quite sure how.  

New Report: Shortage of “Disease Detectives” in Local Health Departments Puts Cities at Risk

By Big Cities Health Coalition and Council of State and Territorial Epidemiologists staff

Epidemiologist, noun
epidemiologist \ˌe-pə-ˌdē-mē-ˈä-lə-jist
An expert scientist who studies, detects and tracks injuries and disease in our communities.

Epidemiologists serve on the front lines of public health, protecting Americans and the global community. When health threats emerge, these “disease detectives” investigate. They identify the causes, factors and patterns associated with illness, determine who is at risk, collect evidence to recommend preventive actions, and rapidly implement control measures. Epidemiologists also respond to major health hazards including emerging threats such as Zika and Ebola, as well as natural disasters such as floods and hurricanes. They also work on chronic issues facing communities including obesity, diabetes, cancer, HIV/AIDS and motor vehicle crashes.

Big Tobacco is marketing vapes to our kids, so our city took them on and won — it’s the FDA’s turn now

By Tomás Aragón, MD, DrPH, Health Officer and Director, Population Health Division, Derek Smith, MSW, MPH, Tobacco Free Project Director, San Francisco Department of Health

This blog originally appeared here in the Hill.

The FDA recently announced that it considers a new surge in teen e-cigarette use to be an epidemic, and will give e-cigarette manufacturers 60 days to prove that they are not marketing to kids. This is a very welcome move for those of us who have been pushing to prevent teen tobacco use. Our city recently took on the makers of e-cigarettes and won. The FDA should take San Francisco's lead and do everything it can to protect kids from Big Tobacco.

Hurricane Harvey: In the Eye of the Storm

By Big Cities Health Coalition Staff

It’s been one year since Hurricane Harvey hit Houston and the surrounding area with record-breaking rain and devastating floods which inflicted injuries, infectious diseases, chemical exposures and mental trauma on residents. Public health officials from the Houston Health Department, a member of the Big Cities Health Coalition, were on the front lines in the lead up to the hurricane and its aftermath. Today, many are reflecting on the events of those four historic days in August 2017 and what lessons were learned, and can still be learned, from the disaster.

Let schools be places for learning—not “JUULing”

By Brian A. King, PhD, MPH, Deputy Director for Research Translation, Office on Smoking and Health, Centers for Disease Control and Prevention

Remember your high school bathroom? If it was anything like mine, the bathroom was a fairly foul-smelling place that you wanted to leave as quickly as possible.

But things are changing. Kids are flocking to school bathrooms across the country faster than the cafeteria on pizza day. School bathrooms have become places where students gather to socialize and use e-cigarettes—in particular, e-cigarettes shaped like USB flash drives that deliver a high level of nicotine.