Member Spotlight: Rahul Gupta

July 27, 2017 | ASTHO Staff

Rahul Gupta, MD, is state health officer and commissioner of the West Virginia Department of Health and Human Resources, Bureau for Public Health. The mission of the West Virginia Bureau for Public Health is to support healthy people and communities and help shape the environments within which people and communities can be safe and healthy.

What was the experience or motivating factor that compelled you to become a state health official?

As a local health officer for almost six years, I had the privilege to experience public health at the ground level. From having one of the highest immunization rates during the H1N1 pandemic event to establishing school-based immunization clinics and modernizing the agency, I was fortunate to work with a team of individuals that achieved remarkable success for the department in its over 100-year history. This also allowed us to become the first health department in the state to apply for national accreditation. However, in January 2014, we suffered a terrible environmental disaster in which several thousand tons of a chemical leaked into the drinking water supply for 300,000 people, resulting in an unprecedented do not use order for several days. This was a life-changing event for countless families, including mine. Whereas some chose to leave the area, I resolved to help strengthen our policies as a state health official.

Was there someone who influenced you to lead a health department?

Shortly after completing my training, I began a private practice in rural Alabama and certainly enjoyed helping individuals in the heart of Dixie. However, each day, I would encounter elderly individuals who had to choose between medication and food. It became clear that my education and training had not prepared me to address the many challenges—the policies and social determinants of health—that my patients faced. Therefore, I embarked upon learning the public health and policy aspects of medicine to help my patients reach their full potential.

What is your morning ritual?

My mornings have gotten a little easier since our twin boys left for college last year. Now my wife and I get to function as a unit. We wake up at 5:30 a.m. and go on a run after some stretching exercises. I usually read the news and have a breakfast of homemade yogurt, almonds, and fruit. We both pack our lunches and then depart for work around 7:30 a.m.

What do you do to stay healthy?

In addition to a daily workout, I am a vegetarian. I am mindful to avoid excess of any particular food, especially those with high fat or sugar content. I make sure to get at least 5-6 servings of fruits and vegetables a day. In addition, I attempt to catch up on sleep on the weekends, if necessary, and try to remain stress-free on a daily basis.

Where is your favorite vacation spot?

When possible, I try to travel to India to visit my favorite spot—the Taj Mahal. The most memorable vacation spot I have ever visited was a place in the northern Himalayas bordering Tibet called Ladakh.

What are your favorite hobbies?

My favorite thing to do is spend time with my sons. I also enjoy writing, gardening, and cooking.

What is your state doing to address the opioid epidemic, and how are you supporting the 2017 ASTHO President’s Challenge?

There are a number of initiatives that West Virginia has embarked upon to address the opioid epidemic, and there is significant emerging data that these initiatives are making an impact. This includes reforming prescribing habits, education, regulatory reform, broadening naloxone and treatment access, as well as the enactment of Good Samaritan laws.

To support the 2017 ASTHO President’s Challenge, we wanted to take a comprehensive approach to address all of the actions identified in the challenge. Therefore, with the support of Gov. Justice and the state legislature, we were able to pass HB 2620 into law during the 2017 legislative session. This created the Office of Drug Control Policy (ODCP), which is under the supervision of the state health officer.

ODCP aims to strengthen multi-sectoral collaboration by identifying existing resources and prevention activities in communities that advocate or implement emerging best practices and evidence-based programs for the full substance use disorder continuum of drug and alcohol abuse education and prevention, including smoking cessation or prevention, early intervention, treatment, and recovery. Acting as the referral source of information, using existing information clearinghouse resources, relating to emerging best practice and evidence-based substance use disorder prevention, cessation, treatment and recovery programs, as well as youth tobacco access, smoking cessation, and prevention, it will optimize the use of cross-sector data for decisionmaking. It further establishes a mechanism to coordinate the distribution of funds to support local programs that could encourage substance use prevention, early intervention, treatment and recovery through efficient, effective, and research-based strategies that will help improve prevention infrastructure, reduce stigma, and change social norms while increasing protective factors and reducing risk factors in communities.

In addition, ODCP will oversee a school-based initiative that links schools with community-based agencies and health departments to implement school-based anti-drug and anti-tobacco programs; review both the Drug Enforcement Agency and West Virginia’s scheduling of controlled substances and recommend changes that should be made based on data analysis; and develop recommendations to improve communication between healthcare providers and their patients about the risks and benefits of opioid therapy for acute pain, the safety and effectiveness of pain treatment, as well as the risks associated with long-term opioid therapy, including opioid use disorder and overdose.

How did your career in public health begin?

With admission to one of the top medical schools in India at the age of 17, I quickly realized the role of public health in my training and its considerable impact on addressing some of the most compelling health challenges, such as infant and maternal mortality, nutrition, and the spread of communicable diseases. This was especially true in a nation such as India, which could not afford to invest a significant portion of its GDP to address health-related issues. As a junior resident, I helped lead the first ever Pulse Polio campaign in New Delhi, which was subsequently replicated by other states and ultimately led to the eradication of polio from a nation with over a billion people. This experience was one of the many that taught me how consequential decisions and robust commitment in the face of formidable adversity can lead to transformative changes within a society. This was also perhaps the experience that helped me differentiate between the significance of policy actions at the individual and population levels.

What do you find most challenging about public health?

The risk-averse nature of public health is what I find most challenging. For instance, it is no secret that Americans are dying as a result of the opioid epidemic, which remains the most significant public health disaster this nation has faced in its 240-year history. Drug-related deaths are continuing to rise faster than ever. Approximately 60,000 Americans are estimated to have died due to drug-related causes in 2016 alone. That is the equivalent of a Boeing 737 crashing every single day during the entire year. With West Virginia leading in the per capita overdose death rate, the challenge to implement policy and regulatory measures that will help address this extraordinary public health disaster often keeps me awake at night. Unfortunately, because these numbers have become the norm, we as a nation may have become complacent. With no end in sight, it is the moral imperative of public health to call for extraordinary measures to help address this disaster.

What are your primary public health priorities?

During my tenure, we have created a detailed state health improvement plan, as well as an agency strategic plan. Our plan aims to address

1. Tobacco use leading to its elimination.
2. Obesity, including its consequences (such as pre-diabetes).
3. Substance use disorder and mental health.

After decades of stagnation, we have recently demonstrated a decline in smoking rates in pregnant women attributed to initiatives launched in 2015. Similarly, we are seeing improvements in other areas. We are currently in the process of conducting statewide assessments with the aim of pursuing accreditation in the coming months.

What is your vision for the future of public health?

That is a very interesting question. In the 21st century, it is time to change how we as a society view public health. As the causes of death and disease continue to experience a revolutionary change, so must public health. As the manner in which we communicate with our colleagues, partners, and society at-large transforms, so must public health. And finally, as the nation advances, albeit slowly, toward understanding the evolution of healthcare from individualistic to community-wide approaches to improve health status, so must the public health community.

The future chief health strategist must provide evidence for a return on investment (which exists, by the way; we just have to find it!), lead health-in-all-policies discussions, and develop a visionary approach that will guide us for the next 100 years. However, just having a new vision is not sufficient. We must encourage new leadership skills and competencies, including those beyond public health which are essential to helping our shifting healthcare system meet the demands of public health in the 21st century.

What are the most important lessons you’ve learned during your career in public health?

I am glad to have joined a transdisciplinary field such as public health early in my career. This helped me learn how to interweave an evidence-based scientific approach with the power of stories to help others connect to pressing public health challenges. By continuing to volunteer my time to see patients at a local charity clinic, I am able to relate directly to the individual-level outcomes resulting from population-level decisions. While most of us want to make the world a better place, it is this type of grounding that I find most useful. It is through my public health career that I have come to realize that sustainable improvements in the health of communities can only occur when those communities have a stake in the process.