Faces of Public Health: Oxiris Barbot, Commissioner of Health, Baltimore City

Faces of Public Health is a recurring editorial series on NewPublicHealth featuring individuals working on the front lines of public health and helping keep people healthy and safe. Today’s profile is Oxiris Barbot, M.D., Commissioner of Health for Baltimore City.

For decades Baltimore has been plagued with high rates of serious illnesses such as diabetes, heart disease and HIV/AIDS, and struggled with social problems including unemployment, poverty and violence that often lead to poor health. As a result, Baltimoreans are living too sick and dying too young.

Earlier this year, the Baltimore City Health Department and Baltimore’s Mayor Stephanie Rawlings-Blake, unveiled Healthy Baltimore 2015, an ambitious plan for improving the health of Baltimore citizens within the next five years.

NewPublicHealth spoke with Oxiris Barbot, M.D., Commissioner of Health for Baltimore City, about the new plan and early implementation steps.

NewPublicHealth: Tell us about Healthy Baltimore 2015.

Dr. Barbot: The plan combines traditional health care and prevention solutions with strategies to improve conditions where people live, work and play, such as reducing the density of vacant buildings and liquor stores in a community. It also calls for a commitment from every city agency, the health industry, the private sector, and local communities, including businesses, neighborhood associations and faith organizations.

NPH: What data was used to help inform Healthy Baltimore 2015?

Dr. Barbot: We analyzed data that the city had collected over a number of years, including health surveys conducted by the department and homicide statistics from the city police, to identify the top causes of premature death in the city. Using this information, we were able to select ten areas for action—areas where we could have the greatest impact—and set specific targets for improvement, for example reducing smoking rates by 20 percent and the number of obese adults by 15 percent.

NPH: How has the city begun implementing the plan?

Dr. Barbot: Mayor Stephanie Rawlings-Blake has directed all city agencies to consider the health implications of policies and regulations in their purview. From social services, schools and the library to the parking authority and the police department, all have a role to play in improving health in the city.

In addition, the city has created a cross-agency task-force, with representation from each government agency, to lead implementation of Healthy Baltimore 2015. Together, these leaders will review the ten priority areas of Healthy Baltimore 2015 and identify areas where they can strengthen existing efforts and where they can do more. We think this health-in-all-policies approach has the potential to be transformative.

NPH: What is an example of this type of cross-agency collaboration to improve health?

Dr. Barbot: We have a number of food deserts in the city, with some residents traveling up to 30 minutes to get to the nearest supermarket, so increasing access to healthy and fresh food is a top priority for us. One way we’ve been able to bring healthy food options to residents living in these food deserts is by partnering with the city’s library and public schools on Baltimarket, a virtual supermarket program. Through the program, residents can order groceries online and have them delivered to their neighborhood library branch or local school pickup site. [NewPublicHealth recently wrote about Baltimarket.]

NPH: In an op-ed for the Baltimore Sun earlier this year, you noted that Baltimore City ranked last in the 2011 County Health Rankings for Maryland. How important are tools like the County Health Rankings for public health departments?

Dr. Barbot: My hope is that County Health Rankings is generating a lot of discussion in terms of ‘what are we doing and is it getting us the outcomes we need?’

In Baltimore, the Rankings helped us look at what we are doing in a different way, and reaffirmed the need to move beyond traditional medical or public health approaches and work with other sectors and community partners to solve the health problems in our city. The County Health Rankings also helps us better advocate for our city and more easily draw distinctions about how our city is different from the rest of the state—even though we collect our own detailed data for the city, we don’t have the resources to do comparisons to the other counties in our state.

For counties with limited resources, I think the County Health Rankings can be a powerful tool to guide where resources can and should be directed.

To follow the progress of Healthy Baltimore 2015, read updates on Dr. Barbot’s blog (Take Care, B’more) at http://takecarebmore.blogspot.com.