Tuesday, November 9, 2010

Three of a kind

It’s lonely being a state surgeon general.

As of today we have three — Joseph Thompson of Arkansas, Ana Viamonte Ros of Florida and Kimberlydawn Wisdom of Michigan. They told a packed Annual Meeting session audience what it’s like blazing the trail as a state-level public health champion.

“When I was the lone surgeon general, I was kind of concerned. It’s kind of lonely to be the only one, and your conventions are small,” Wisdom joked. “I was so happy when there were others.”

Each of those three states has a different model of how the surgeon general’s position is structured, but all have been appointed by their respective governors. A University of Michigan study highlighted at the Tuesday session, "Health Reform and the Changing Role of the Public Health System: The Experience of Arkansas, Florida and Michigan," found people like the idea of a state surgeon general but that a lack of “bi-partisan buy-in” by state legislatures makes the person in the seat vulnerable to political criticism.

“And public health certainly doesn’t need any more criticism than it already deals with,” researcher Jodyn Platt said to laughter from the audience.

Having a state public health bully pulpit has led to great success. Arkansas' Thompson cited a 45 percent reduction in youth smoking rates in recent years, Wisdom talked of a wellness effort that’s being led by middle-schoolers in under-served Michigan communities and a well-supported anti-obesity agenda, and Florida's Ros blocked efforts to scale back childhood vaccinations.

Still, Wisdom was powerless to change the minds of decision-makers who did not earmark any of the state's landmark tobacco settlement funds for tobacco prevention and cessation in Michigan. And legislatures in both Florida and Michigan have sued to halt implementation of the federal health reform law.

Thompson said he doesn’t know if his input kept his state out of that fray, but he was sure to make it clear that the law’s implementation will mean $3.5 billion in yearly federal money to insure more Arkansans.

Former U.S. Surgeon General David Satcher, also an advocate of state surgeons general, said he’s “optimistic” about health reform implementation.

“We have a tremendous opportunity, I think, with health reform,” Satcher said. “The fact of the matter is, we’re serious as a nation about the prevention agenda.”

State surgeons general can move that agenda forward, Ros said, but only if politics take a back seat.

“I think we struggle in public health to define who we are,” she said. “I think it’s very important to de-politicize public health. We are non-partisan. We should be bi-partisan.”

— D.C.

Above, former U.S. Surgeon General David Satcher moderated an Annual Meeting session on health reform and public health. Photo by Jim Ezell/EZ Event Photography

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