New York Public Health Now

s3e07 Partisanship and the Bifurcation of Public Health: Brown SPH's Dr. Ashish Jha's Roadmap for Bridging the Widening Cultural Gap

• New York State Deparment of Health (NYSDOH) • Season 3 • Episode 7

Share episode

Joining Commissioner McDonald and Executive Deputy Commissioner Morne is Brown University's School for Public Health Dean Dr. Ashish Jha.  They discuss Dr. Jah's strategies to "departisanize" public health and reach out to communities that feel disaffected, emphasizing the importance of understanding diverse perspectives in addressing current and future public health challenges.

Hear Dr. Jha's personal story, from his initial aspirations to become a journalist to his transition into medicine and his influential role at the federal level assisting the Biden administration as White House COVID-19 response coordinator and most recently as the Dean of Brown University's School of Public Health.

Dr. Jha shares his innovative approaches to public health education, including his focus on diversifying the student body, not just along racial lines, but also socio-economic and political, and his focus on integrating new voices and perspectives while preparing students for the evolving challenges and media landscape facing the next generation public health workforce.

If you have an idea for topics we should discuss, please let us know: PublicHealthNowPodcast@health.ny.gov

Jim McDonald:

Jim, welcome back to New York Public Health Now. This is the podcast where you talk about the why's you can decide what to do. Hello, I am Dr.Jim McDonald, Commissioner of the New York State Department of Health, coming to you from downtown Albany, the 14th floor of Corning Tower in Empire State Plaza in what actually is a rather cloudy day here, which is unusual for us, but great to be here again today. And Johanne, how are you today?

Johanne Morne:

I'm doing great. It's my favorite season, and all is well.

Jim McDonald:

Well that's good. I'm really excited about today's episode. We have not just Dr. Ashish Jha with us, who, yes indeed, is a national household name. I would submit you as one of the nation's doctors. By the way, he cares about the entire country, is a frequent contributor on every national broadcast there is. I had the privilege of getting to know Dr.Jha a little bit when we were in Rhode Island together, which was really just a treat for me. He's at Brown - Brown School of Public Health. We'll talk more about that in just a minute, as we talk about schools of public health too. But Dr. Jha is a accomplished practicing physician and an internationally trusted leader in Public Health. He's recognized for his work tacking some of the greatest population health challenges of our time including Ebola and COVID 19. He served as President Biden's COVID 19 response coordinator. During a critical period in the pandemic, March of'22, he led efforts to expand access to vaccines, improve testing availability, and served as an advocate for investments in indoor air quality. Dr.Jha is also an esteemed academic, having been a professor at the TH Chan School of Public Health and Harvard Medical School, where he directed the Harvard Global Health Institute. Today, he serves as the Dean of Brown University School of Public Health right there in downtown Providence, Rhode Island. He's helping to guide the next generation of public health leaders in doing it with alacrity and with expertise. Dr.Jha grew up in India, Canada, and here in the United States. He's earned his medical degree from Harvard Medical School, complete his residency at the University of California San Francisco. Did not know we had that in common, I did some rotations there at UCSF, and he returned to Boston for his fellowship in general medicine. He also earned his Master of Public Health from Harvard and was elected to the National Academy of Medicine in 2013. With that, Dr. Jha, welcome. Thanks for joining us today.

Ashish Jah:

Hey, Jim. Thank you so much. Well really both of you for having me on, I'm excited to spend some time chatting with you guys.

Jim McDonald:

Yeah and we have a lot to talk about today, but let's start with you. You know, I read a little bit of a background, but hardly covers the real you, can you just tell us a little bit about you? Using anecdote, whatever's on your mind.

Ashish Jah:

Sure, you know, you got the biography, I would say, really, from an early in my - since I remember, my goal had always been to try to do work that would have impact in the world. When I was in high school, what I thought I would do is I'd become a journalist in Chronicle and shape history, as they often say. Got to college, became an economics major, just thought economics was super interesting, but then ended up going to medical school and you know, in some ways, the rest is history. The one thing I will say from medical school onwards is I have always tried to combine both clinical practice and the discipline of medicine with public health and the perspective that public health brings to health issues. And so, that has always been a pretty motivating thing is, how do we find that intersection and every health crisis we face, I find myself remembering that it's a crisis where both medicine and public health have to come together to weigh in on these issues. So making sure that those two intersections are real, or those two fields are really working together, has been a passion of mine for a very long. Personal note, I've got three kids, wife, live in Newton, Massachusetts, and love the Boston Celtics, and was thrilled that the Boston Celtics were at the White House recently.

Jim McDonald:

Oh that's awesome. That's great. It's I love hearing people's journey. You know, you started you want to go into journalism, economics, and you find up in medicine. It's interesting, little known fact about me, my first major in college was photography, and then went into biomedical photographic communications. You see a little slight hint there. And then eventually I decided I really wanted to be a doctor. Now when I think about what inspired me to go to medicine, you know, that's something I can grab onto, but I'm just curious, like, do you want to just tell me a little bit - ut what inspired you to go into medicine? You know, because inspiration, it's a very personal thing, but you want to just give me a little tidbit what that was.

Ashish Jah:

Yeah, so if you want me to give you an honest answer, Jim, which I suspect you might want.

Jim McDonald:

Always love honesty.

Ashish Jah:

OK, so, I didn't used to say this, but I feel like I'm now old enough and I should just be honest with people. I went into medicine for the reasons you're never supposed to say in your medical school application. My mom really, really wanted me to go.

Jim McDonald:

That's awesome.

Ashish Jah:

And so she had wanted one of her two sons. She has two sons, my brother and I and to go. My brother's older, and he had no interest, therefore it was either me or bust. And I felt like I didn't want to disappoint my parents, and so I went into medicine. I will tell you that upon arriving in medical school, I actually fell in love with medicine. So maybe she knew something and I didn't, or maybe I just got lucky, or I don't know what happened, and I'll tell you what part of medicine I fell in love with almost immediately. And very few people like say this about early medical school, but it was true for me. I loved the fact that, like, I was learning something that had two elements. One was, it was deeply practical. Like I remember the day we had the lecture on asthma. Everybody has heard of asthma. No one outside of medicine or people, unless they have it, really know what asthma is. I remember sitting there going, wow, that's asthma. That's so cool. And like, this is how you take care of it. And so it felt very practical, and it also felt like it was demystifying something that we all knew and cared about. And that combination was very, very motivating, and so I tell the story of one morning, I woke up in medical school and said, Boy, I really wish I was in medical school. And thankfully, I was already there. The rest has been history. I have never looked back and wondered if this was the right field for me. I mean, who knows, maybe if I'd gone down something else, I would have loved it as much. But I have just loved being a physician, and I have loved the field of medicine for what it brings to people's lives.

Johanne Morne:

Well, I think there are many people who have heard from you, learned from you, that are very grateful for your mother's wish. So, glad that you followed through there. In your career, you've held significant leadership roles in public health that includes serving as a White House COVID-19 response coordinator. What did you take away from that experience, and how has that experience shaped your current work?

Ashish Jah:

Yeah, even going into that role a little bit, but really serving in that role, you realize that, and I'll tell a story in a second, but you realize, like, public health is so much more than just, like thinking about the medical issues that affect a population. Health, first of all, is shaped by many, many things. That's that's something I had, I think, appreciated even going into that role. But then, in that role, you know, I was the COVID-19 response coordinator, and that was my title, "Coordinator". And coordinator was actually a very good way to capture what I did, because the US government in many ways represents all the different facets of our society. We have a Department of Commerce, that thinks a lot about business. We have a Department of Labor, that thinks a lot about labor. Obviously you have CDC, that is very much focused on public health. And I can keep going: Department of Defense, Department of State and all of them represent different aspects of our country. When you have a health crisis, of course you need to bring a health lens to it, but you actually also have to bring the lens of workers and the lens of business owners and the lens of our military and how they need to think about these things. And fundamentally, what I came to to learn and understand is that you do public health well - when you can bring all those perspectives to bear, in your decisions. That if you take too narrow of a view, you can get one part right and the whole thing wrong. So, so much about public health is that broader societal perspective. As I said, I had an inkling of that. The story I often tell is, you know, before I went I was advising a lot of governors and mayors in 2020 and 2021, on how to manage the pandemic. And I remember a conversation with a governor, who will go nameless, because these are all private conversations. I was having a conversation with a governor and the Governor's team about a bad outbreak of COVID that was happening in part of their state. And I, you know, got on the Zoom call, and I said, look, the first thing is, in that community, bars are open. Bars are a very efficient way of spreading COVID, this is pre-vaccine. And I said "I would really think about shutting down bars for a couple of weeks because the outbreak is so bad." And the governor looked at me by zoom and said, "OK, so your suggestion is shut down bars." I said, "Just in that area for a couple of weeks." The governor said, "Thanks for that advice, what's your next advice?" And I realized, OK, that person wasn't gonna go down that path. And as I finished my sort of five suggestions that I had come in with, they ended up doing one and kind of a second, and I realized no one has elected me. I'm accountable to no one. I'm giving honest advice, but the governor has to make the decisions and the trade offs, and has to think about, what will it mean for that community, and what will it mean for workers, and what will it mean for businesses, and those are really important considerations that only an elected leader can make. And the job of public health experts is to give the public health advice, the Governor called me back two months later on a different issue, I was just as clear and bold in my advice, but I have to understand that I am one input into a broader decision, and that broader decision has to be made by people who are accountable to the people. That's how democracies work. And that, I think, really shaped my thinking even when I went to the White House, that public health is an important input, but ultimately, Joe Biden, as the President of The United States is accountable to Americans, and he's got to make a decision that takes into the perspective a whole host of Americans with different views and different values. I'm sure you guys live a version of this every day. You are, you know, the team that executes on, but also advises the governor of the great state of New York. The governor has to make a complicated set of decisions in which you're a really important input, but you can't be the only input - and you're not. And at times it can feel frustrating in public health, and I tell my public health colleagues and friends, it's not frustrating, it's actually the way it should work. Give your honest advice and step back and let them do their job.

Johanne Morne:

It sounds as though much of your approach is about being inclusive and about being intentional and understanding the many factors that people have to consider when decisions are being made. I appreciate that. So, in addition to all of the work that you've done, you also serve as the Dean of the Brown University School of Public Health, where you're in a position to shape the future of public health education. What does being a dean look like, and do you have the same approach in that position, or do you have a different approach?

Ashish Jah:

It's definitely influenced right? So here's how I think about it, and I say this to my team, I say this to my faculty, some of the best public health work is being done by people who don't think of themselves as public health people. Some of the most important work in public health is being done by people who are computational biologists or economists or sociologists. I mean, I can keep going, but the point is that public health is an outcome - better public health - where you can get to it through a variety of means. So, the traditional physician like me or an epidemiologist or biostatistician, we've got lots of them, they're awesome,this is not a critique of the traditional fields of public health. It is important, but it is not enough. And so a lot of the faculty we've hired, when I reach out to them initially, they're often like, public health school? And I'm like, your work is deeply public health. And they're like, I guess so, I guess so. And there is a complexity there, because then we often ask ourselves, like, which department will they go into? Well, we work those out. But ultimately, I'm trying to create a more flexible School of Public Health that cares about finding great scholars and great practitioners who do important work and don't live in the traditional silos of public health. Because the traditional silos are important, but they're not enough to address the big public health issues. The second way it has influenced me, there's probably a bunch of others too, but one other one that comes to mind immediately is our school is in Rhode Island, Rhode Island is a very blue state, and I remind my faculty that we are training the next generation of public health leaders, not just to go be public health leaders in blue states. They need to be public health leaders in purple states. They need to be public health leaders in red states. People in other parts of the country and diverse groups of Americans have different perspectives and what public health is and what it should do, and what the role of government is, and how much should government be involved in health decisions, and how much should government shape health decisions? And if we are going to be effective, as a school in training the next generation of leaders for America, we have to train people in a variety of different perspectives and help them understand what Americans think and feel. It's hard because most of our faculty are, I'm just gonna be very blunt about this, most of our faculty are left to center, they're Democrats. That's not good, that's not great. So part of what I've been trying to do without asking people's political affiliation, right? I'm not gonna be like, "are you a Democrat or a Republican" before I hire you, but I am trying to hire some of the practitioners we have hired to come in as professors of the practice. I've tried to hire people who have worked in red states and have been effective in those communities, have worked with conservative political leaders, because that perspective is very, very important for our students and for our other faculty who are here. So that I think has also shaped how I've been doing this public health school. I'm sure there are probably other ways too, but those two come to mind as trying to build a very different school of public health that doesn't do all the standard, traditional stuff that schools of public health have always done.

Jim McDonald:

Yeah, and I want to build on that a little bit. Brown has a great reputation for preparing exceptional public health leaders. I've actually worked with many of them in my career, they're really all over the place and I think that adademic rigor balanced with some common sense, and just quite frankly, a realistic view of the world, really helps a lot. More of a pragmatic question, how does your school educate future public health leaders? And what programs do you offer to support the mission? You have a pretty robust program over there, it's not like we just spit out infectious disease people, you know?

Ashish Jah:

We do have a pretty robust program, and here's how I think about this. One is we have a motto, which is long standing well before I arrived, which is; when you come to Brown School of Public Health, you learn public health by doing public health and that is something we have doubled down on. You're right, we did send a lot of our students to work in the Department of Health, we worked in other state agencies, we worked out in the community. I actually think it's great to get superb scholars teaching you in the classroom, but there's nothing like when the rubber hits the road, and you're like, okay, here's my epi model and this is how humans are supposed to behave. And then you go out into the community, you're like, oh, humans don't always behave the way they're supposed to based on epi models. And if you don't know that, you're not going to be a good public health leader. So we really believe that you got to get out into the community, whether it's in government agencies, NGOs, community based organizations, wherever - and be involved there, as you're learning. So, that has been very much one part of our strategy. You know, another part of our strategy has been to really think about bringing in new voices into public health and new experiences into public health. And I'll tell you about one program I'm particularly proud of, is our health equity Scholars Program. It's 20 students a year, 10 from HBCU's, historically black colleges and universities, five from Hispanic serving institutions, and five what we call Rhode Island scholars - people who have a deep, long standing relationship with Rhode Island. So if you just went to college here, that's great, but that doesn't count. You've got to show me that you've either grew up here or have a commitment to this state, because I just feel like as a school and as a university, we owe the state a lot, and we should be doing that. And we've built these programs, it's tuition free, we get a whole bunch of training beyond just getting your master's degree, have a network, mentors, etc. We built these programs because when I looked and said, you know, there's a lot of phenomenal students at HBCUs, for instance, just to start there - at historically black colleges universities, who never think about coming to Brown for a School of Public Health or Masters of Public Health degree, not on their mind. They don't think that that's something that's an option for them. And so being very intentional and saying, actually we think we can build a great program where you'll feel at home, where you'll learn a lot, and you'll contribute a lot, we're in the fourth year of that. It's going great and, you know, and my hope is that that's how we build a totally new generation of public health leaders who don't generally see themselves going into public health. Again, it's part of a broader theme, which is, you know, look, I think public health did a lot of things right in the pandemic. It clearly got some things wrong. There's no, I mean, it's not monolithic. If we're going to do better, we need different people coming into public health, meaning different ways of teaching them. We need different ways of engaging and while still staying true to our core values of scientific rigor and caring about the public. So that's a bit of what I'm trying to do with these different programs.

Johanne Morne:

I'm taking it all in, and I'm just really, really so impressed with the vision that you have and recognizing that maybe the traditional way in which we view things is not the only way for us to advance. So, and of course over time comes change, right, and including within public health education. From your perspective, what have you seen as far as the evolvement of public health education, and what are the trends that you think are shaping for the future?

Ashish Jah:

Yeah, those were good questions. Whatever answer I give you now, I promise you, it'd be a different answer a year or two from now, and probably would have been different two years ago. There are a few things we're clearly doing differently, and I would say it's not like we've figured it out. We're making progress on this. One is around health communication. We had a very traditional model of health communication, you taught people how to do health communication. When we looked at our curriculum, we realized we were teaching people how to do health communication in the year 2000. The information landscape looks radically different. Just nothing like it, the information landscape has become incredibly fragmented. There is no, one public. There's lots of different publics. You reach them all in very different ways. I think we all live in information bubbles. There's very little cross talk across bubbles, we've got to figure out how to do better on that. We've got to train our students to live in that world. Even social media has had this profound impact, and now social media is fragmenting. One of the things that we're really trying to be very intentional on, and I would not say we have figured this out, and we're going, you know, like gangbusters, we are on a journey is we want to train the next generation of public health leaders to be far more adept in engaging in communication in this very different landscape. You know, traditional press releases, news pieces in the local news or national news, it's just not how you reach people the same. I mean, you reach some people that way, but large chunks of people you don't reach that way. So we're really trying to be intentional about that, I think that's very, very important. People are like, well why is this so important? And I'm like, because public health begins with the public and if you can't engage with the public and you can't communicate with the public - you can have the best programs, you can have the best vaccines, you can have the best whatever, if the public isn't on board, you're not going to make a difference. So really focusing on that has been one part of our strategy. Certainly in the last year or two since I've come back from Washington. There are really big trends, you know, I think a lot about, how is AI going to reshape the practice of public health? And so, we have been trying to be intentional on that. AI certainly is shaping how people themselves engage with health information, probably most people are not even aware of how it's shaping what they do, but when they Google things, when they look up stuff on their phones, a lot of the information they're getting is now very AI driven. We need to understand that better in public health. But also a lot of the types of information we used to have to provide, it's going to get done by itself. So then what is the role of public health practitioners in a world where AI is going to become ubiquitous? Again, I promise you, I do not have the answers to those questions. We are, struggling is maybe a little bit of a strong word, we're thinking deliberately about it, and we're trying to incorporate that into our educational strategy because if we don't want to train people who are just going to be effective two years from now, we need to train people who are going to be effective 5, 10, 20 years from now and want to, want to arm them with tools to do that.

Jim McDonald:

I think that's fascinating, the way you just talked a little bit about health communications, how it's changing, and you reminded me of, you know in the 1960s visionary Marshall McLuhan, when he did this book Master the Medium, and I remember being exposed to that in early college. I had no idea where the medium - where communications, was going. I had no idea how far it was going to go, and he saw it back in the 60s and it's amazing where communications has gone. I think you're right about artificial intelligence, you know, it's one of the things I'm studying it, but I still have a big box in my brain called "I don't know what I don't know", but I'm really intrigued about where it's going to take us. And, going back to Brown, a little bit about where do you find your graduates - when they when they complete their studies at Brown, are there specific areas of public health that you're seeing greater demand? I mean, where do you see people getting pulled now into, when you look at the Brown Masters of Public Health graduate, where do you see them going? I mean, you know they're showing up at health departments, I'm sure. But like, I wonder if the demand is different now for public health professionals than it used to be.

Ashish Jah:

Yeah, I think a couple of things are happening, Jim. I do think the demand has changed. I mean, there are a lot of public health departments, as you know, there was a lot of turnover after the pandemic. Even during thepandemic, a lot of turnovers, just a lot of public health professionals just got burnt out by how hard the work was - a lot of the vitriol and hatred they face and anger. So, there are a lot of opportunities in public health departments to kind of replenish that, so I think those are always opportunities. I will tell you, and I'm very encouraging of this, though not maybe not everybody is, I'm seeing a lot of opportunities in the private sector. One of the things that we talk about is we want to make sure our students are really well trained in methodology and data, because we think that's going to hold them in good stead over the long run. Well, that training becomes very attractive to pharmaceutical companies, to biotech companies, but I don't just mean tofocus on the life sciences, there's lots of other types of companies and private sector companies that think, "oh boy, it's really helpful to have people with that kind of training." So, we're seeing a lot of a lot of pull from there. And then, you know, we saw some chunk of students who kind of go on and get a PhD afterwards. I mean, not a lot, because, again, it's primarily people are going to go into practice. Some people go work at the federal government, work at the CDC, go work at other federal agencies, or thinktank. So it's a broad mix, but if you're asking, like, what's different, I do think the growth in the private sector has been interesting to me to watch, that sort of pulling a lot of our graduates.

Johanne Morne:

Like with everything in life, education also comes with challenges. What are some of the biggest challenges that you face as far as educating students today?

Ashish Jah:

Part of what happens in these things is, if you try to diversify your student body - and when I say diversify, I mean sure by like traditional metrics, like race, ethnicity, gender, and all that, but I actually mean like background and where people come from and where they grew up and what their life experience has been. Then, on one hand, you get a really rich class experience of people who grew up in rural Mississippi and people grew up in Manhattan, right? And that's great to have them right next to each other, but that often means they come from very different educational backgrounds, and that poses a whole set of challenges. I mean, the easiest, not the best, but the easiest way to teach is you have a super homogeneous group. You know exactly what they know, what they don't know, and then you just teach them. Much, much harder to teach a much more heterogeneous group of people, because they come with different skills, different experiences. So our faculty have talked about how the strategy to super diversify our, the background of our students, while they love it and are completely on board, has made educating harder. I'm like, yeah, doing important things is always harder. It's always easier, you know, to do the thing that you've always done. So, again, I don't mean to, like, discount the hardness of that, but I think I'm not surprised and I think that's fine. That's a challenge. You know, the other challenge is, we're in a period of time where at least in broad swaths of the policy world and et cetera, people don't want to talk about public health. Public health was so in their face for so long that they feel like they want to break. We're still doing well in terms of getting applicants, I don't mean to go down that path, but you know, private philanthropists, other people who really support schools of public health, a lot of them are just feeling like, I don't know that I can do any more in public health. So, there's some real challenges there. I think that'll come back. I think that's just a post pandemic lull. My view is, as long as we stay focused on doing important work that makes a difference in people's lives, public health will continue to be a very, very important field for funding, for students, for faculty, and it'll have its ups and downs in crisis. You can't worry about that.

Johanne Morne:

Right. Which is the experience that we have with everything in life, right? There'll always be ups and downs. And so, you know, I asked about the challenges, at the same time I think there's definitely so many things to be hopeful for. And as you talked about, you know, perhaps those who have some fatigue, if you will, will find their way back, recognizing that public health is essential to the health and the satisfaction of individuals. So, what makes you hopeful about the future of public health and I suppose, aligned with that, what are the probably top one or two things that do still worry you?

Ashish Jah:

It's an interesting question. So first and foremost, there is no shortage of challenges to deal with, right? So, COVID is like largely in the rear view mirror, it's still around, we've got to manage it - but it's hardly a crisis. But, we have so many important public health crises to deal with. Obviously, the opioid crisis, the mental health crisis, issues around cardiovascular disease and cancer and all the things that public health can do in those fields remain really important. Surgeon General just put out another report on tobacco, we've made so much progress there, but that is not finished business, as you both know so well. So, there is no shortage of big challenges. And that reminds me that when people start feeling a little bit down and they're like, oh, you know, like, there's all this backlash against public health. I'm like"look, people count on us." They're often not aware that they count on us, in some ways, they count on you, you're on the front lines of doing these things, but they also count on public health experts and professionals like an academic to generate the evidence and generate the data and help people on the front lines, like health commissioners and others actually affect change. So, I say to people "like buck up, I understand it's been a hard couple of years. We have a lot of work to do, and let's get going." And it does motivate me, and it does motivate our folks, because they just remember that like we have, we have really important issues to tackle. The thing I worry about is, I still think public health is too much in its own bubble. I worry a lot about, I mean I've talked about the idea of like, building leaders, training leaders, to work in red states, purple states and blue states, not just blue states. I worry that not enough people in public health understand both the depth of the division that has formed after the pandemic, and how it is up to us to do a better job of reaching out, connecting with communities that feel disaffected by public health. And, there is no kind of going back to business as usual. We can't be like, "OK, let's just go back to 2019 and the way we did things." Pandemics change societies - they always have. This pandemic has changed society because it's accelerated some trends, has made some things - we've got to, in some ways departisanize public health. I always remind people that I think this is true, that the state with the highest childhood vaccination rates in 2019 was Mississippi, one of the reddest states in the country. And so I don't want to hear about, you know, partisan nature of vaccines. There's nothing inherent about vaccines that should be partisan. We've got to get back to that. And the way that's going to happen is by outreach and communication and engagement. So, I think there is really important work for us to do. If your question is, what worries you, I just, I worry a little bit about whether people inside public health fully appreciate the importance of that outreach to communities who are somewhat disaffected by us and are not convinced that we are representing their best interests. We've got to do a better job of connecting with them.

Jim McDonald:

You know, the pandemic was a population trauma, and I think we're still suffering from that. One of the things you and I talked about in the past was just a how there needs to be a period of a national forgetting, if you will. And it's one of those things where, you know, as we move beyond the population trauma, you know, there's going to be a new president, January 20th, and I'm just wondering, like, you have any advice for the president coming in? I mean, you've been giving advice to presidents for a while here. And I'm just curious, I mean, if you had a bully pulpit, which you do right now, what would you say?

Ashish Jah:

Yeah you know, and I've spent, actually even the last couple of weeks, talking to a bunch of the folks who are part of the HHS transition for the Trump team. And what I have reminded them of is that there is a very proud bipartisan tradition of trying to make improvements in Medicare and Medicaid programs, in supporting vaccines. When I said, you know, in 2019 the highest vaccination rate for kids was in Mississippi, that was under a Trump presidency, that was under Alex Azar as Secretary of Health and Human Services, and Bob Redfield, the CDC director. My primary advice is, obviously Republicans are gonna do things a little differently than Democrats. Like, that's actually a feature, not a bug, that's our country, right? We have different people with different views, but like stick to the tradition that has gotten us so much gains. There are reforms that are needed at the federal level, in agencies, no question, but there's so much good there as well. And it's a cliche, but do not throw the baby out with the bath water here like this is a place where, make the reforms, some of the reforms are going to be substantial, trust me because having been in the White House, I got to see ways in which our agencies can be quite dysfunctional. I'm all in on that. But do it in a way that preserves the core of the American public health and biomedical enterprise because it's actually a pretty good enterprise. It's gotten us a lot of good things to happen in the last decade, half century, etc. So that's been my general advice, is, do it your way, but don't, don't turn your back on the system that has been so important for us.

Jim McDonald:

Yeah, Dr. Jha, thank you so much for joining us today and sharing your wealth of knowledge and lived experience - and I think that's really good advice. You know, as we go forward together. Because we are going forward together, as a country,

Johanne Morne:

Absolutely, it's been such a pleasure to hear your insights, as well as learn about the future of public health. Really, it's been inspiring.

Ashish Jah:

Well, thank you and thank you both for your leadership. I, you know, I one piece of advice I give all my students and faculty as well is, if you get a chance to serve in government, you should try everything possible to say yes. It's an extraordinary opportunity. It's hard. You don't get paid very well. You get a lot of people angry with you a lot of times. But, it is God's work. And so every time I talk and have a chance to connect with people who are on the front lines, leading major public health agencies, like the two of you guys, I just want to say thank you for your service. Your service is not just for the people of New York, but it actually has effects for the whole country. It's hard, but I'm glad that you're both doing it, and thanks for having me on and giving me a chance to chat with you both.

Jim McDonald:

Yeah, thank you. And thank you for those encouraging words, that's very kind of you. You know, as we wrap up this episode of New York Public Health Now, it's been great to have Dr. Ashish Jha on, the Dean of the School of Public Health at Brown but also one of the nation's doctors. By the way, if you have a topic you'd like us to cover, reach out by email at PublicHealthNowPodcast@health.ny.gov.

Johanne Morne:

You can find our latest episodes on Apple Podcasts, Spotify, Overcast and YouTube. Just search for New York Public Health Now or the keyword "NYSDOH" to subscribe and be notified when we release new podcast episodes - that happens about every other week.

Jim McDonald:

And if you like our podcast, it would mean a lot if you left us a review, it helps us reach more listeners. For New York Public Health Now, I'm Dr. Jim McDonald, Commissioner of the New York State Department of Health.

Johanne Morne:

And I'm Johanne Morne, Executive Deputy Commissioner here at the Department of Health.

Ashish Jah:

And I'm Ashish Jha, thank you so much for having me on.

Jim McDonald:

And thanks for listening.

Monica Pomeroy:

New York Public Health now is a production of New York State Department of Health's public affairs group. Michael Wren is the executive producer and engineer, with additional production support provided by Sarah Snyder, Genine Babakian, Barbara Stubblebine, Alicia Biggs, Monica Pomeroy and Kyle Kotary. We welcome your feedback! Please email us at PublicHealthNowPodcast@health.ny.gov

People on this episode

Head Shot

Dr. James McDonald

Host
Head Shot

Dr. Neil Muscatiello

Host
Head Shot

Johanne Morne

Co-host