Baltimore City Health Commissioner Dr. Leana Wen emphasized that the overall health of Baltimore City’s residents is tied to the health of the city.
Last January Wen, an emergency physician and patient and community advocate, was appointed by Baltimore Mayor Stephanie Rawlings-Blake to lead the Baltimore City Health Department, the oldest health department in the United States, formed in 1793.
Wen talked to the Greater Baltimore Committee about health as a priority for all sectors of Baltimore’s community. She will speak at the GBC’s Newsmaker Breakfast on Jan. 12.
Health is tied to everything
Wen said that health impacts all facets of life, including education, children’s development and holding down a job.
“If a child is in so much pain that they can’t focus in class from their untreated dental infection,” Wen said, “or they have significant trauma and they were never able to tell anyone, or they don’t have glasses and therefore can’t see, then how are they going to be able to develop, how are they going to be able to learn, how are they going to be able to hold down a job later in life?”
Health is also tied to jobs and the economy and affects whether families feel safe in their neighborhoods and where they send their children to school, Wen said.
“I make the argument constantly in our work that no matter what it is you’re interested in, that everything ultimately comes down to health,” she said.
Wen said the biggest health challenges and the health department’s three primary areas of focus are: youth health and wellness; addiction and mental health; and care for the most vulnerable.
“If there’s anything that the unrest in April showed us it’s that we cannot just look at people as being perpetrators of violence,” Wen said. “We have to look at individuals as victims of trauma and how that trauma then ties in to systemic racism, structural poverty, health inequities and other inequalities that we have the opportunity through public health to resolve.
“We have to address these fundamental inequalities,” she said. “Studies have shown that by leveling the playing field that we’re then able to improve the economy, increase jobs, reduce the number of sick days, increase people’s happiness and in general make for a healthier, happier and more productive workforce.”
Health programs as a catalyst for change
It has been almost one year since Baltimore Mayor Stephanie Rawlings-Blake appointed Wen to serve as health commissioner. Wen points to three major accomplishments in her first year on the job.
First, she is proud of the department launching the “very aggressive” overdose prevention and treatment campaign Don’t Die. The public education campaign works to help reduce the stigma associated with overdose. In fact, Wen can administer the antidote drug Naloxone – a a prescription medicine that can stop an overdoseprescription medicine that can stop overdose – to Baltimore’s more than 600,000 residents. She also touts that more than 6,000 people are trained to properly administer the drug.
“This campaign is an innovative model and it’s one step in the right direction of turning Baltimore from being the heroin capital into the recovery capital,” Wen said.
The second accomplishment is engaging local hospitals, doctors and public health leaders around certain goals, Wen said. For example, when there was the suspected case of measles in Baltimore this year, these leaders collectively issued statements about the importance and life-saving benefits of immunizations.
“It’s in everyone’s best interest – both financially and because we all care about the city – to work toward city-wide goals,” Wen said. “The city health department can serve as neutral conveners.”
The final accomplishment is “getting health onto the agenda of everything,” Wen said.
“In the wake of the unrest,” she said, “we saw what happens when there are hundreds of people who don’t have access to medications.”
Treating mental illness appropriately
More than eight out of 10 people in jails use illegal substances and four out of 10 have diagnosed mental illness, Wen said.
“We have a history, not only as Baltimore but as our country, of incarcerating people who have a medical illness,” she said. “Jail and prison, they’re not the right place for us to treat people who have addiction, who have mental illness. This is not good for their health, it’s not good for the economy and it doesn’t make sense. We’re sending people to jail and then they’re leaving with no more treatment or care management for what’s going to happen next.”
The department, Wen said, is working to help reduce the stigma associated with mental illness, talk about mental illness as a disease and advocate for and provide services to Baltimore’s vulnerable populations, which includes people experiencing homelessness, addiction and mental illness.
Building a team and her leadership style
As the leader of the health department, Wen oversees approximately 1,000 employees and a $130 million budget. She considers building and leading a “tremendous team” to be among the department’s top accomplishments.
During April’s unrest Wen instructed employees to go home but many declined.
“It was a poignant example of how this is the work that I am the most proud of,” she said. “It’s building this team, motivating the team and working with the team to accomplish our goals that really is, I think, this is by far the most significant accomplishment.”
Wen stressed that she believes in hiring people who are genuine and mission-oriented.
She also believes in strong, constant communication to all constituencies.
“I believe in communication to the point of over communication,” she said. “There are so many silos in every sector. My job is to make sure people understand what our mission is, how we’re doing it and to keep saying this message in many different ways so that there’s no ambiguity about where we stand and to always lead with transparency and accountability.”
Relationship with the Baltimore business community
Wen, who is serving in her first government job, views the partnership between the health department and the business community as a natural one.
“Our role as the health department is to serve as the neutral conveners of all the different groups,” she said, “whether it’s nonprofits or hospitals or employers or whoever. It’s our job to bring everyone together and say ‘here are the health goals, here are the goals that we have as a city. Let’s make sure that we all buy into these goals. Let’s see how these goals apply to each of us no matter who we are or where we’re at. Let’s understand that achieving these goals is beneficial to all of us, for whatever our individual bottom line is and let’s come up with strategies together for finding out how we can do that.’”
For example, addiction and mental health affects everyone, regardless of the sector.
“Addiction and mental health are so closely tied to the economy and crime,” she said.
Wen wants to engage the entire business community to develop collective goals and shared strategies to tackle the city’s biggest health challenges, which she said are the unmet health needs of children, addiction and mental health and growing health disparities.
“Anyone in the business community who is concerned about the future of the city should care about the health of our children because that directly impacts their ability to be educated, and therefore the perpetuation of intergenerational poverty,” Wen said. “That’s a huge issue.”
She said more people die from overdose than from homicide annually.
Wen noted other health inequities in the city: one in three African-Americans live in a food desert compared to one in 12 whites; African-Americans make up 65 percent of Baltimore’s population and more than 85 percent of Baltimore’s African-American population is living with HIV; and African-Americans are five times more likely to die from HIV in Baltimore than whites.
“These are numbers and statistics and they’re bad but they also make the health of everyone worse,” Wen said. “We need to invest on reducing inequalities to improve not only the care for our most vulnerable but also to improve the care of everyone.”
Register to attend the GBC Newsmaker Breakfast with Wen on Jan. 12 at the GBC.