Public health officials need to do more to take their preventative health message to the community level and need help from health care workers, like doctors and nurses, to become more effective.
That’s the message delivered by Natasha Bagdasarian, MD, MPH, Michigan’s chief medical officer, who addressed the “Michigan Health Agenda” during special plenary sessions Nov. 15 at Wayne State University School of Medicine.
A 2005 School of Medicine graduate, Dr. Bagdasarian leads the state’s public health initiatives, advocating for programs and funding to address issues affecting the state’s population, including vaccination efforts , maternal and fetal health, combating the opioid epidemic and increasing cases of syphilis. .
In some ways, Dr. Bagdarsarian said, public health is a victim of its own successes. Because so few people remember the ravages of polio before the Salk vaccine, or know people who live with the effects of the disease, an “out of sight, out of mind” situation sets in, as was the case case for smallpox. Americans forget the critical role public health played in vaccination efforts to nearly eradicate disease.
She noted that in today’s political climate, widespread parental distrust of vaccinations is paving the way for outbreaks that were brought under control decades ago. A statewide dashboard, for example, can identify Michigan public schools with a vaccination rate of 10% or less. Public health, in collaboration with health systems, must develop methods to break down distrust and prevent the possibility of outbreaks of measles and other diseases, which can only be contained through “herd immunity.”
While cases of syphilis – a very treatable disease – are increasing, so are cases of congenital syphilis. To help deal with the situation, she would like emergency rooms – where many patients with the disease seek treatment – to offer routine testing, with the option for patients to “opt out.”
The United States, she said, has an appalling rate of premature births and fetal-maternal mortality among the world’s most prosperous countries. This rate, both nationally and in Michigan, is much higher among black mothers and babies. One way to reduce that rate, Dr. Bagdasarian said, is to advocate for Medicaid-provided doulas, both during pregnancy, at birth and for 12 months after delivery.
The COVID-19 pandemic has taught public health officials many lessons, she said, but chief among them was the importance of meeting the public where they are. Bringing vaccines to communities, especially underserved communities, was critical to vaccine acceptance, as demonstrated by the Wayne Mobile Health fleet. Introducing vaccines and health services to communities and relying on trusted community leaders have increased confidence in vaccines. This lesson must be continued by considering the face of public health in communities and working with community leaders to inspire trust.
“We need to meet people where they are,” Dr. Bagdarsarian said.
Dr. Bagdasarian also called on audience members to use their voices to advocate for public health to local, state and federal officials, noting that his own mother frequently writes to the White House.