Baltimore Takes a Broader View of Public Health
Baltimore is at the forefront of a movement to expand public health's arena to include social ills such as gun violence and drug addiction.
Leana Wen, just back from a trip to Israel, is jet-lagged. But Baltimore’s health commissioner doesn’t have time to be tired. In the next three days, she’s appearing on a CNN segment on opioid abuse, speaking alongside U.S. Attorney General Loretta Lynch and writing two college commencement speeches.
It’s a frenzied level of activity that doesn’t surprise those who work with Wen. The leader of the nation’s oldest continually operating health department has taken a fresh and aggressive perspective on what her agency can and should tackle. Appointed in January 2015, Wen was still getting adjusted when the riots over the death of Freddie Gray erupted. The unrest gave her the opportunity to talk about health in broader terms and to a larger audience.
“The No. 1 thing I do in my daily life is bring together everyone, from faith leaders to leaders of nonprofits and foundations, and making them think about health as this umbrella concept everything falls under,” Wen says. “We’re framing every social ill around health.”
It’s a movement that is beginning to take hold in public health departments across the country. Historically focused on disease outbreaks, restaurant inspections and disaster preparedness, more city and county health agencies are starting to tackle issues surrounding population health that include gun violence and drug addiction.
For Wen, investing in these sort of programs are more important than ever in the wake of police-involved shootings -- and subsequent protests -- across the country.
"Public health officials would all agree that violence is a public health issue. But we have to demand a seat at the table," she says. "Community leaders might just think of it as a criminal justice issue, but we have a responsibility to bring public health in the discussion."
To this end, Wen and her team have introduced a dizzying array of initiatives. In September, she ordered that naloxone, a lifesaving antidote to a heroin overdose, be available without a prescription. This year alone, her team has introduced legislation requiring warning labels for sugary drinks, created interactive “health maps” of the city, and launched a program to ensure that all young schoolchildren have access to eyeglasses.
Even before Wen took over, the department had launched a couple of big programs that have shown encouraging results. Though controversial, its Safe Streets program, which uses reformed gang members to intervene in potentially violent situations, had helped one dangerous neighborhood go a year without a shooting. B’More for Healthy Babies, an initiative to curb Baltimore’s high infant-mortality rate, reduced infant deaths by more than 20 percent between 2009 and 2014.
Before B’More for Healthy Babies, says Sonia Sarkar, the health department’s chief policy and engagement officer, “there were several initiatives throughout the city on infant mortality, but nothing was moving the needle because they weren’t talking to each other. We are always thinking, ‘How do we bring people together and get them to realize their common goals?’”
The issues Wen is dealing with in Baltimore haven’t been abstract ones for her. She emigrated from China when she was 8 and lived in what she calls “pretty tough areas of L.A., areas not unlike parts of Baltimore.” Before coming to Baltimore’s health department, she was an emergency room doctor and co-wrote a book on misdiagnoses, When Doctors Don’t Listen.
While she’s receiving praise for her work in Baltimore, there’s uncertainty on the horizon: Mayor Stephanie Rawlings-Blake, who appointed Wen, leaves office at the end of the year.
“As an appointee of the mayor, every administrative change comes with some level of anxiety,” Wen says.
It’s too soon to say whether Wen’s programs will stick in a city still considered one of the country’s most dangerous, but she wants to stay to see her vision through.
“I see all of the residents in this city as my patients,” she says. “There are problems, and I need to diagnose them.”
*This story has been updated from the version that appears in the July print issue of the magazine.