Dr. Letitia Dzirasa, a Johns Hopkins-trained Baltimore pediatrician with experience in high-tech information systems and community-based health care, will take over as the city’s health commissioner on March 11. Find out more here.
By Mattie Quinn
Leana Wen never had her sights set on public office. She was happy working as an emergency room doctor and lecturer in medicine in Washington, D.C. And when the position of Baltimore health commissioner came open, in 2014, she was only 31 years old. But a widely respected former commissioner urged her to apply for his old job, and she decided to go for it.
There was no way Wen could have imagined what she was about to get into. Just a couple of months after she moved into her new post in Baltimore, riots erupted in the city following the death of Freddie Gray, an unarmed black man, in police custody. Wen leveraged the unrest to start a conversation about police brutality and poverty as public health issues. “If we care about our children and their education,” she said, “we should also care about lead poisoning in their homes. If we care about public safety, we should also address mental health and substance addiction and the huge unmet need there.”
Born in Shanghai to a family of Chinese dissidents, Wen emigrated to the U.S. when she was eight and grew up in Compton, south of downtown Los Angeles. She graduated college at 18 -- summa cum laude from California State University -- and then went on to become a Rhodes Scholar at Oxford, held a clinical fellowship at Harvard, and wrote a book called When Doctors Don’t Listen.
Whether you're looking at chronic conditions, sexually transmitted diseases or other maladies, Baltimore has some of the worse health outcomes in the state and the nation.
City data shows 19 percent of Baltimore residents have asthma, while statewide it's 14 percent; 30 percent of children are obese, compared with 15 percent statewide; 30 percent of city kids have had at least two traumatic childhood experiences, versus 19 percent statewide.
About 12 percent of city babies have low birth weight, compared with the national average of 6 percent. A quarter of Baltimore residents smoke, while 17 percent of U.S. residents do.
Health officials consider race a driver of many of the disparities in Baltimore, which is 62 percent African-American, compared with 30 percent in Maryland and about 13 percent nationally.
The U.S. Centers for Disease Control and Prevention found that this is the case in many urban areas. A recent survey found more barriers to health care and greater risk of disease for residents who live in predominantly minority neighborhoods when compared to the rest of their counties or states. Poverty is a big factor, but middle-class African-Americans also suffer higher rates of disease.
A comparison of disease rates of Baltimore's black population and the nation as a whole by Johns Hopkins researchers in 2010 found stark disparities: Black infants in Baltimore died at more than twice the national rate, and so did black diabetics. Black Baltimore residents were diagnosed with HIV at a rate 71/2 times the national rate.
Baltimore City statistics also show that blacks are far more likely than white residents to be hospitalized for several chronic diseases and drug or alcohol use, have higher rates of sexually transmitted diseases and report that their mental health is not good.
Data collected by the Big Cities Health Coalition from more than a dozen large metropolitan areas shows Baltimore in the bottom three for many health outcomes by race.
BERKELEY SPRINGS, W.Va. — States that spend more money on social services and public health programs relative to medical care have much healthier residents than states that don’t, a study out today by a prominent public health researcher found.
The study comes as the Obama administration prepares to fund its own research to support the idea that higher social service spending can improve health and lower health care costs. Last week, the Department of Health and Human Services proposed a long-awaited rule that will pave the way for more doctors and hospitals to work closely with social services providers to keep people healthier, such as with home visits or help with housing.
Health care and social services experts in West Virginia, where jobs and access to health care can be hard to come by, cite daily reminders of how improved services can save money later. Their challenge is expanding the reach of the programs they do have. "There's always more need than resources," says Audrey Morris. director of the non-profit Starting Points of Morgan County here.
The new study is the first to compare state spending on social services — which are generally less expensive than medical costs — to spending on Medicare and Medicaidand to residents' health. Many state officials, including those here, say Medicaid claims are busting their budgets and federal officials struggle to rein in Medicare spending on drugs and medical treatments, especially for chronic disease.
Politicians from both parties say health care spending increases, although slowing, are unsustainable, but they disagree often vehemently over how to address the problem. Yale University public health professor Elizabeth Bradley, lead author of the study, is urging more efficient — not more — government spending.
Bradley and her co-authors found that for every dollar of Medicare and Medicaid spending for residents of the average state, an additional $3 was spent on social services and public health between 2000 and 2009, the latest available. Washington, D.C., and states including Colorado and Nevada had the highest ratios of social service and public health spending relative to medical costs - about $5 for every dollar of medical treatment — and were much healthier.
New York and Massachusetts joined traditionally poor-health states including West Virginia, Kentucky and Louisiana with the lowest ratios of social services to medical spending, averaging about $2.30 on social services for every medical dollar spent. People in these states also tend to have higher rates of heart attacks, lung cancer, mental illness and obesity, the study showed.
It's only March, but Baltimore City Health Commissioner Leana Wen already has an embarrassingly full calendar.
She's put together the city's plan for dealing with the Zika virus, launched a campaign against soda and other sugary beverages and overseen an investigation into why so many people in the city are overdosing on fentanyl.
Trained in emergency medicine, Wen, 33, says running the health department in Baltimore is the fastest-paced job she's had.