Member Spotlight: Mark Levine

October 05, 2017 | ASTHO Staff

Mark Levine, MD, is commissioner of the Vermont Department of Health. Levine comes to the position from a background as a clinician-educator, practicing and teaching internal medicine, as well as a variety of administrative roles in graduate medical education at the University of Vermont and UVM Medical Center. Before being appointed commissioner, Levine served as a longstanding member of the Vermont Department of Health’s primary care-public health integration workgroup.

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

As a physician, I have always been interested in helping people lead healthy lives. This requires a lot of individual counseling and slow steady effort. Over the years, I became passionate about the integration of primary care, public health, and prevention initiatives and collaborated with numerous colleagues at the health department and prior commissioners. I firmly believe in applying the wisdom of the health impact pyramid, addressing the social determinants of health, and helping to influence an individual’s decisions as a means of impacting population health in ways that go beyond what I can do as an individual clinician. Reducing the impact of the chronic diseases I once managed daily is critical to the health of our citizens and Vermont’s economic solvency.

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

There was no one particular individual, but I have excellent relationships with two of Vermont’s prior health commissioners as well as with my immediate predecessor, all of whom have enlightened, supported, and encouraged me. I was also a finalist for a Robert Wood Johnson Health Policy Fellowship, and though I did not have the opportunity to pursue the fellowship, the process of personal exploration, self-examination, and networking were certainly formative.

What is your morning ritual?

I rise around five a.m. and exercise, mixing it up between running, the fitness center, and hiking. I then enjoy a bowl of oatmeal and berries, as well as an English muffin with peanut butter and jelly or salmon. Afterwards, it’s off to work.

What do you do to stay healthy?

In addition to the activities described above, on the weekends I like to work on the property, hike, kayak, and snowshoe. I try to model healthy eating whenever possible, although I freely admit that it has taken me awhile to get better at this whole work-life balance thing.

Where is your favorite vacation spot?

I try not to pick favorites so as not to limit my options. In addition, Vermont is so beautiful, it is hard to leave (except when it’s below zero for a prolonged period of time). However, when it comes to vacation, we find mountains and coastlines preferable to cities. Places such as Sedona, Cape Cod, the Pacific Northwest, and Hilton Head tend to repeat themselves. Anywhere in the proximity of the National Wildlife Refuge is also ideal.

What are your favorite hobbies?

Running, hiking, birdwatching, reading (although not nearly enough pleasure reading), watching the Celtics, enjoying family, and being outdoors. The kids live some distance away, but we strive to visit as much as possible.

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

I am so proud that Vermont is a recognized leader in addressing the opioid epidemic. Richard Baum, acting director for the Office of National Drug Control Policy, just visited and noted that our hub and spoke treatment model (based on the health home model) is “an incredibly valuable national model,” and one that numerous states are now trying to adapt to suit their needs. Vermont has the highest per capita opioid treatment capacity of any state and our waiting list will soon approach zero with the opening of our final hub. We also have a very active governor-appointed opioid coordination council, as well as an abundance of local initiatives and community responses. Vermont has a statewide recovery center network to keep all the dimensions of this chronic disease under ongoing management, including housing and unemployment. The health department has numerous primary prevention strategies, media campaigns targeting the appropriate social media for each age group, as well as an incredible parenting skills and communication skills website, SBIRT training programs, and SAMHSA-funded regional prevention partnership grants across all districts. New prescriber rules, collaboratively developed with the prescribing community, have just gone into effect, and our prescription drug monitoring program just underwent structural enhancements to help the clinician community manage data and de-identify comparison data by specialty. We are actively developing school-based prevention education programming and expanding student assistance professional programs to impact the next generation. In addition, there are numerous traditional secondary prevention and harm reduction strategies, including safe storage practices, syringe exchange programs, the Most Dangerous Leftover disposal campaign, and state-wide free distribution of naloxone kits.

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

I enjoy engaging with a highly competent, qualified, and knowledgeable team of public health professionals. I remain awestruck by their depth of expertise. I also love the fact that public speaking, media appearances, and invited talks allow me to continue to do what I have always loved about medicine, which is engaging with interesting people.

What are your primary public health priorities?

The first focus is prevention, and enlisting the governor’s support on this. Primary areas include Vermont’s 3-4-50 health promotion-disease prevention program, which addresses the three unhealthy behaviors that lead to the four chronic diseases that cause over 50 percent of deaths each year in Vermont. Broadening this program into a true public-private collaborative is also a priority, as is universal home visiting for newborns, oral health for kids, and falls prevention as part of healthy aging. The second priority is continuing to guide Vermont’s efforts to combat substance use disorder, particularly as it relates to prevention. The third priority is a renewed focus on prevention efforts surrounding tick-borne illness rates, as Vermont is unfortunately becoming a leader in this.

What is your vision for the future of public health?

I endorse the contemporary definition of public health, which includes building a new generation of intersectoral partnerships that draw on the perspectives and resources of diverse communities and actively engaging in health action. This is how public health succeeds. State health officials and health departments will be even more highly engaged in the strategy that goes on at the nexus of public health, medical care, population health, and health policy. And public health leaders will need to extend strategies that exist at the intersection of health, science, and policies such as health in all policies, as well as evidence-based public health programs. To do this important work, public health institutions will need to help communities buy-in to the values and principles of public health.

What is something you’re most thankful to have been a part of during your career in public health?

Since my public health career has been so brief, I can unequivocally say that it is an honor to work with employees at the Vermont Department of Health, all of whom are so dedicated and engaged, as well as an agency of human services that has delightful and collaborative colleagues, all of whom are committed to providing the necessary services and improving the health of all Vermonters. I am also thankful that the people I work with value the unique lens through which I see many issues, my understanding of the patient-physician perspective, as well as the challenges our healthcare system poses.

How has social media helped advance public health within your state?

The media campaigns that have been done by our alcohol and drug abuse program illustrate this well. Any effort to engage youth and young adults, who have the brains that are most susceptible to the effects of substances, must be addressed on their own turf and chosen social media. Hence why we have designed appropriately focused marketing media campaigns. We are also able to better target other public health messages, be it vector borne diseases, environmental health, or primary prevention across a variety of platforms.