Member Spotlight: Nirav Shah
Nirav D. Shah, MD, is director of the Illinois Department of Public Health. The department’s mission is to protect the health and wellness of the people of Illinois through the prevention, health promotion, regulation, and control of disease and injury.
What was the experience or motivating factor that compelled you to become a state health official?
I had the opportunity to serve as an economist at the Cambodian Ministry of Health early in my career, and my experience there really solidified and honed my interest in public health. I left Cambodia and ended up going to law school, and while I love the law, I had been looking for a way to translate the skills I gained practicing law and in medical school to get back to public health.
Was there someone who influenced you to lead a health department?
I wouldn’t say there was one single person. I’ve seen firsthand the impact of poor health on communities. I lived on the south side of Chicago, where social determinants of health are pretty stark (e.g., crushing asthma rates). Your zip code is such a strong indicator of your health status. I wanted to do something about that. So in a sense, the people in these communities really inspire me to do this work.
What is your morning ritual?
The first thing I do is check my work messages and respond to anything urgent. Then I focus on practicing what I preach. I go to the gym at 6 a.m., walk my dog up to five miles (under four miles and he tears up the house!), drink a protein shake, brush my teeth, then hop on the train with the paper and get to work by 9 a.m.
What do you do to stay healthy?
In addition to my morning ritual, I love to cook and mostly follow a plant-based diet.
Where is your favorite vacation spot?
Well my first response to this was “what is vacation?” But when my wife and I can both coordinate time away, we love Northern California—for the great hiking and the delicious food.
How has public health changed during your time in the field?
There is more awareness about disease outbreaks. I came in at the tail end of the Ebola crisis and now we’re grappling with Zika Virus. I’ve found there’s much more recognition that a disease somewhere can quickly become a disease everywhere, especially given that we have one of the largest international airports in our backyard. That awareness has translated into an acknowledgement of the value of prevention and preparedness.
Also—and we’ll get to this later—but something new is definitely the notion that substance misuse is a public health issue.
What do you love most about the public health work you do?
I love that unlike many other areas of healthcare, public health is truly multidisciplinary. To put together a good, collaborative team in public health, we need folks with dozens of different backgrounds and skill sets (epidemiology, communications, medicine, regulators, licensed environmental health practitioners, nurses, etc.). This makes us so unique and comprehensive in our strategies to improve health.
And, as corny as it may sound, I love making a difference. The impact of public health work isn’t always direct or immediate, but it is powerful. We’re getting ready to celebrate 10 years of being smoke-free in Illinois indoor spaces. In 2008, 21.3 percent of Illinoisans identified as smokers. In 2015, it was 15.1 percent. That is a very tangible public health outcome.
What are your primary public health priorities?
As alluded to above, we’re really focusing on substance misuse. Right now, the opioid crisis we’re facing is akin to what we faced at the height of the HIV crisis. The deaths and social segregation we’re seeing are eerily similar. In 1995, there were 51,000 AIDS deaths during the peak of the epidemic. Last year, there were roughly 52,000 opioid-related overdose deaths. A lot of other states are dealing with the same crisis and determining their roles in addressing it. And we’ve seen that state borders don’t stop the spread of this epidemic.
Another priority of the Illinois Department of Public Health is lead poisoning prevention. Despite the fact that lead poisoning has been in the news lately, in many ways it’s a true public health success story, as the number of children with elevated blood lead levels has dramatically decreased. Nevertheless, it remains an issue in Illinois and we want to be clear that the greater risk here is still lead-based paint.
What are the most important lessons you’ve learned during your career in public health?
Probably the biggest thing I’ve come to appreciate is the importance of communication. I’m not talking just about risk and crisis communications, which are obviously essential, but the value of strategic communication. Good communication leads to better preparedness and healthier behaviors, which are what we’re here to promote. There has always been this idea that when public health professionals do our job well, nobody knows it because we serve as this invisible shield. I’d like to make that shield visible so that we demonstrate our worth, build the public’s trust, and ultimately do our jobs better.
How has social media helped advance public health within your state?
The biggest advantage of social media is that it builds connectivity with our local health departments. We all follow each other, share in successes, and laud each other’s accomplishments. Additionally, in public health campaigns, we can be consistent in our messaging and responsiveness.
For instance, we’re in the middle of National Public Health Week. We solicited stories from all the local health departments, built them into a comprehensive social media campaign, and shared that plan with all of the local health departments in the state. We’re coordinating themes for each day and together we’re demonstrating the value of public health.
Obviously, it also increases outreach, helps in surveillance and monitoring efforts, and corrects misinformation during outbreaks. It’s how we need to operate in this era, and I think it makes our jobs easier, in many ways.