Member Spotlight: John Wiesman

January 11, 2018 | ASTHO Staff

John Wiesman is president of ASTHO and secretary of health for the Washington State Department of Health. The department of health in Washington is a cabinet-level agency in a decentralized state, with 35 local, independent health departments governed by their own boards of health and more than 1,700 employees overseeing public health areas such as: disease control and epidemiology, health promotion, vital statistics, environmental public health, state public health laboratories, health professions and facility licensing, rural health, and emergency preparedness and response.

Wiesman, who has served as secretary of health for the Washington State Department of Health since April 2013, has dedicated his career to transforming health departments from providing individual clinical services to implementing policies, systems, and environmental changes that make healthy choices easier and less expensive. In Washington State, Wiesman is working to create the healthiest next generation, end AIDS, reduce suicide deaths, and identify and fund foundational public health services across the state.

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

While this was not a job I had preplanned as part of my career, it was a natural trajectory. I started my career in local public health as an intern doing HIV counseling and testing—as part of the first group to be trained in Connecticut—while working toward my MPH in chronic disease epidemiology. That led to my first job in a health department performing all aspects of HIV and AIDS work. From there, I moved into management and became a local health department director for nine years, right before becoming secretary of health—a position I felt compelled to accept due to the ability to have larger system impacts on public health.

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

Why of course—the most fabulous Mary Selecky (alumni-WA), my predecessor and friend. Like many state health officials, she mentored me as a local director and gave me opportunities to lead statewide, such as chairing a committee looking at the future of public health in Washington state.

What is your morning ritual?

At my best, I get up and work out before breakfast. My workouts vary from running, aerobic machines, swimming, cycling, and more recently high intensity impact training. I have trained for and completed three sprint triathlons. Having a goal helps me immensely. Then it’s off to my 40 minute commute from Tacoma to Tumwater. But I have not been as consistent as I would like. My New Year’s resolution is to find another sprint triathlon to motivate more consistent workouts.

What do you do to stay healthy?

In addition to what I discussed above, I also try to do as little work on the weekends as possible, and I get a deep tissue massage every other weekend.

Where is your favorite vacation spot?

Anything requiring an airplane! My favorite vacation spot is going somewhere I haven’t been. I’m always interested in exploring new places.

What are your favorite hobbies?

In addition to travel, I enjoy going to the movies, out to eat, and taking walks with my husband.

What is your state doing to address the opioid epidemic?

Like many others, Washington state is focusing its efforts in four areas:

1. Preventing substance use in the first place. This includes implementing a prescription monitoring program, with a focus now on linking with electronic health records so that data is automatically pulled into the record at the time of service and getting prescribing reports to prescribers.
2. Increasing access to treatment, especially medication assisted therapy. Gov. Inslee is seeking additional funding for treatment in this year’s supplemental budget.
3. Preventing overdose deaths, primarily by increasing access to naloxone.
4. Improving data systems and evaluation of these efforts. I am proud to say that Washington state, through the health agencies’ medical directors, was the first state to prepare and implement chronic pain treatment guidelines.

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

I mark my career in public health with the AIDS epidemic, followed by emergency preparedness and response and now health systems transformation (and the opiate crisis) where public health and clinical care are coming together to promote wellness from a holistic health perspective. Many of us have refocused our efforts on prevention and working across systems to create a culture of health that addresses all the determinants of health, with a desire to address health inequities. This has had an increasing emphasis on maintaining our gains in infectious disease control, shifting clinical care to the clinical system and focusing on policy, system, and environmental interventions to combat chronic disease, especially the underlying behavioral health risks.

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

The opportunity to work with people whose driving mission is to improve the health of all people.

What do you find most challenging about public health?

For me the most challenging thing is staying focused on a few things when there are so many health issues that need to be addressed with dwindling financial resources.

What are your primary public health priorities?

Coming into the job they were and they remain: ensuring that public health has a prominent leadership role in health systems transformation work, preventing childhood obesity, increasing funding for the local and state governmental public health system to do a better job, and addressing climate change. This is in addition to the ongoing and important work to increase immunization rates, prevent tobacco use (and more recently, vaping), as well as keeping our food, water, and air safe. I should also add ending AIDS, especially now that we have increased access to health insurance and PrEP as a tool for prevention, decreasing firearm deaths—starting with suicide prevention, which account for the vast majority of firearm deaths in Washington state—as well as addressing the opioid crisis, preventing unintended pregnancies (especially by increasing access to LARC), and giving our children the healthiest starts we can by creating safe, stable, nurturing environments and systems. See what I mean about the difficulty of staying focused on a few things! Oh—and the next infectious disease threat, of course. Add to that modernizing data systems (we absolutely need to have common platforms for disease reporting and surveillance systems) with fewer applications to support those systems (informatics leadership), as well as modernizing our communications and customer service tools. And then there is getting my department reaccredited. Are we done yet?

What is your vision for the future of public health?

My vision is an adequately funded federal, state, and local system that can do the job it’s supposed to do. Full stop.  

What are three things public health leaders can do to educate and engage the communities they serve?

First is to get out and listen. What do people care about? What are their priorities? What is holding them back? What is already happening and how can we help?

Second is to use our bully pulpit to highlight the importance of prevention and the many determinants of health, with a focus on healthy starts for children and addressing the social and structural determinants that create unjust health inequities.

Third is to modernize our communications infrastructure and systems so that we can communicate with our communities in the manner that fit their lives. This means getting the information they want and need at the time they desire it.

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

Fighting the HIV and AIDS epidemic. I had the good fortune to enter public health when the HIV test became available, making syringe exchange programs available, as well as the development of effective treatments that make HIV a chronic disease and treatment as prevention in terms of making HIV undetectable equals untransmittable, and now having PrEP (and being the first state to have publicly funded it) to help keep the high-risk safe. Having been a volunteer in an early HIV vaccine trial, I thought we would have a vaccine by now. The course has been different than I imagined, but we are now at a place where it is reasonable to have a program that ends AIDS, as well as a hepatitis B elimination program. How exciting is that!

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

Be tenacious. Be patient. Be a good partner. Listen and ask questions first for understanding. Then co-create solutions with the people who are living the experience. Evaluate your progress. What gets measured is more likely to get done—so do it and be very aware of what you are not measuring, because that will likely not get done. Create a support system for yourself. Role model health and a good work-life balance. When you are no longer enjoying your job, move on and let someone else take it from there.

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

Frankly, we are trying to figure this one out. Having a social media presence takes resources and it’s rapidly changing, so one must be nimble. That takes not only financial resources but the right human resources and a tolerance for risk.

I think a potential benefit is building a very robust and diverse group of followers where trust is established so that when an emergency arises and people need information quickly from a trusted source, we can use our social media presence to rapidly communicate the right message at the right time. Then, through the responses, we can obtain information about what people are hearing, believing, thinking, and needing and feed that back into our response. It’s the two-way relationship that I think makes this most valuable and the network created for rapid dissemination when needed that makes it most useful.