Member Spotlight: Ed Ehlinger

November 02, 2017 | ASTHO Staff

Ed Ehlinger, MD, is commissioner of health for the Minnesota Department of Health. As commissioner, Ehlinger is responsible for directing the work of the Minnesota Department of Health, which is dedicated to protecting, maintaining, and improving the health of all Minnesotans. A past-president of ASTHO, Ehlinger previously served as director and chief health officer at Boynton Health Service at the University of Minnesota, as well as director of Personal Health Services for the Minneapolis Health Department.

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

The lead public health position within a state has the opportunity to influence policies, programs, and systems that will influence the health of the public for an entire state now and into the future. When one’s governor asks you to take that position, it’s difficult to say no. When else would one have this kind of opportunity?

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

Seeing the impact that previous state health officers have had in Minnesota and in other states reinforced the importance of the role of a state health official in creating optimal health.

What is your morning ritual?

My morning includes coffee, ironing a shirt (a form of meditation), taking a shower, reading the newspaper while eating breakfast, kissing my wife goodbye, and heading out the door.

What do you do to stay healthy?

To stay healthy, I aim to get enough sleep, eat breakfast, take the stairs, bicycle, cross-country ski, and consume food in moderation.

Where is your favorite vacation spot?

I love variety, so I try to avoid visiting the same place twice. Every spot contains something special and I try to embrace and enjoy that unique feature when I’m there.

What are your favorite hobbies?

My favorite hobbies include horseshoe pitching, children’s music, stone carving, and writing.

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

Opioid use and addiction, along with other forms of substance abuse, suicide, homicide, cirrhosis, depression, and anxiety, are among the diseases of disconnection and despair that arise from adverse societal conditions that destroy social connection and hope. While implementing best practices regarding rescue, treatment, and rehabilitation, we are planning to use lessons learned from fetal and infant mortality review programs to identify factors leading to these unsatisfactory outcomes and then develop community-based strategies that build community resilience and social cohesion. We plan to create community-based prevention initiatives that will address all diseases of disconnection and despair, not just opioids.

How did your career in public health begin?

Beginning my health career in the midst of the “War on Poverty” was pivotal to the trajectory of my professional career, in that the need to address health disparities was repeatedly emphasized in my training and practice. My initial effort to address the disparities was to join the National Health Service Corps and practice medicine in a medically underserved community. However, it only took a few months to realize that just providing clinical care was insufficient to reduce disparities and create health in a community. Too many other social and economic factors were negatively affecting health. That realization led me to public health, where I’ve been trying to integrate medical care and public health approaches to address both the diseases and the socio-economic conditions that impact health.

How has public health changed during your time in the field?

Public health has always been based on science, but in the last 30 years there has been a growing recognition that social science and political science are just as essential as biomedical science. The realization that living conditions are more important determinants of health than healthcare has expanded the scope of public health to include policy, system, and environmental change (PSE) strategies as core to public health practice. Continuing the classical public health interventions that allowed us to effectively address acute diseases and injuries while adding the new PSE strategies to address chronic diseases and health disparities has expanded the scope and importance of public health. In the process of creating this new and expanded view of public health, it has become increasingly clear that the focus of public health must be social justice.

What do you love most about the public health work you do?

Most of the people working in the field of public health are mission-driven and passionate about the work that they do. That passion for protecting and improving the health of all members of our society combined with their expertise in multiple disciplines makes public health one of the most interesting and satisfying fields to work. My idea of a perfect job is one in which you are doing something of significance, that relies on your education, experience, and imagination to solve problems, as well as one in which you learn something new every day and have some fun. Public health fulfills that definition.

What do you find most challenging about public health?

Public health works to prevent bad things from happening. One major challenge is having people recognize, understand, and appreciate that the work of public health does that. Proving that you kept something bad from happening is difficult, which makes it hard for people to recognize the importance of public health and our society’s need to support and invest in good public health work.

One other challenge is developing risk literacy—i.e., understanding the difference between individual and population-based risk. For example, people overestimate the risk of cancer from small amounts of chemicals in their water and underestimate the risk of cancer from personal behaviors like smoking. People are more concerned about the risks over which they have limited control, even though the larger risks to their health are often things which they can control.

What are your primary public health priorities?

In my opinion, our society is faced with at least two existential risks that, if not effectively addressed, will destroy our society as we know it. One of those risks is climate change. The other is health equity. I support and encourage multiple other agencies and sectors to take a lead in prioritizing climate change in the work of effectively responding to and mitigating climate change and the problems that it’s creating. I work as a partner in the comprehensive and collaborative effort to address climate change.

I take a much more active and up-front role in addressing health equity. Using the bully pulpit I currently have, as well as the Triple Aim of Health Equity as an organizing tool, I have been working to change the narrative about what creates health (i.e., expanding our understanding about what creates health) and forging the partnerships necessary to effectively advance health for all (i.e., implementing a health-in-all-policies approach with health equity as the goal). In addition, I have been working to more effectively engage with and organize communities to advance health equity—that is, strengthening the capacity of communities to create their own healthy future. All of this health equity work is centered around creating social cohesion which, if achieved, will be the antidote to the existential challenges that face us today.

What is your vision for the future of public health?

Over the last 50 years, people have taken public health for granted. We have not recognized its importance and the support that it needs to maintain its effectiveness. Because of that, we are not as healthy as we could be and we confront huge disparities in health and opportunities to be healthy. With healthcare costs rising and the slowing (and often declining) rates of improvements in health, people are beginning to recognize the importance of public health. I believe that we could experience another golden age of public health with the right kind of leadership at the federal, state, and local levels.