Ten Things I Wish Someone Had Told Me When I Became a Health Officer

摘要

Public health, like politics, is the art of the possible. To maximize effectiveness, public health officers in any jurisdiction should (1) get good data and ensure timely and effective dissemination; (2) prioritize and tackle more difficult initiatives first; (3) find, fight, and win winnable battles in areas where progress is possible but not ensured without focused, strategic effort; (4) support and hire great people and protect them so they can do their jobs; (5) address communicable diseases and environmental health effectively; (6) do not cede the clinical realm—public health programs depend on clinical care and on effective coordination between health care and public health; (7) learn and manage the budget cycle; (8) manage the context; (9) never surprise their boss; and (10) follow core principles. This article reflects on key lessons learned in the past 15 years as director of the US Centers for Disease Control and Prevention (CDC) and health commissioner of New York City. Health officers, many of whom are appointed by elected officials, inhabit a world where science and politics intersect. 1 The privilege of serving in this role may be brief. Health officers have a unique and often time-limited opportunity and a responsibility to improve health in their jurisdiction.