BOLD SOLUTION: Sami developed a plan for increasing Medicaid revenue, estimated at an extra $15 million in annual recurring revenue for health services through a novel state plan waiver. Once complete, this will be transformational for the health department. New funding will enable them to tackle new work on gun policy, behavioral health services, asthma prevention and programming, maternal and child health interventions, equity-focused lead home remediations, safety net health care services, and more. They will open a new city health center site for the first time in decades. The expansion will save hundreds if not thousands of lives over the long term in Philadelphia.
Five Questions for Sami
1. Who or what inspired you to enter the field of public health?
Years ago I worked with academic researchers on writing federal grants. For one proposal with a biomedical researcher, I sought a grant for over $500,000 to purchase a piece of equipment the size of a kitchen microwave for a lab. It was to study a rare disease. We won the grant, and the researcher and his colleagues were thrilled. All I could think about was what half a million dollars could have done for the faculty members focused on public health policies and programs. I’m a big supporter of basic sciences and research, but my public health brothers and sisters were working on problems that were huge, pervasive, and comparatively poorly funded. It was then that I decided to pursue a career in public health.
2. What is one of the most interesting projects you’ve worked on?
I worked on a gun violence rapid response team. The summer months were coming up, and two big gangs in the city were raging at each other. One night of violence would lead to another, retaliatory shootings over and over. Bystanders were hurt, and young men and women, mostly African American and Latinx, were dying far too young. Government leaders brokered conversations between the jurisdictions’ gang leaders, who literally met with the mayor and other officials. Public health was at the table, providing evidence and using our convening, epidemiology, and analytical skills.
3. What are the greatest challenges you face in your work?
The defeatist belief that because the problems we confront are so entrenched, and the solutions required are so big, we shouldn’t act unless we can fix it all. I believe in bold incrementalism. Some can talk, talk, talk, but I’d rather act, act, act. There’s strong evidence in public health that the root causes of many health challenges are poverty, racism, and the social and economic injustices that run so deep in the United States. The sugar-sweetened beverage tax in Philadelphia is a great example. Obesity is a large, complex problem. And its root lies in a broken food system, perverse incentives, poverty, and externalities that create unnecessary harm in our nation. We didn’t solve any of that in imposing a sugary drinks tax, but we still made a big difference. Philadelphians will live better lives because of it. Public health can’t do it all, but it can still do so much.
4. What would success in public health look like to you?
In public health, we are good at characterizing problems. We can show you charts, maps, and graphs. Success in public health, for me, would be building the political will among elected officials to value prevention. Elected officials have many expectations placed on them, but building a cadre of elected officials who seek to prevent mortality and morbidity into the future, to save the lives of people they will never meet — that would be a public health success. There’s the old saying that society thrives when old men and women plant trees whose shade they will never enjoy.
5. As a kid, what did you want to be when you grew up?
A school bus driver. I’d ride around my neighborhood on my bike, practicing stops at the corners and mailboxes.