Leana Wen: 'Public Health Is the Responsibility of All of Us'

A Q&A with public health leader Leana Wen, MD, about her new book

A headshot of Leana Wen.

Verywell / Courtesy of Leana Wen

From Baltimore health commissioner to national COVID-19 expert, Leana Wen, MD, MSc, has emerged as a champion for public health.

Wen is well-known for her op-eds in the Washington Post and for serving as a medical analyst to CNN. This summer, the emergency physician and George Washington University public health professor released a new book: "Lifelines: A Doctor’s Journey in the Fight for Public Health."

Conceived before the pandemic, but released in its wake, the book profiles Wen's story of coming to America from China as a young child, becoming a Rhodes scholar, a dedicated physician, the health commissioner of Baltimore, and a reassuring voice that many now turn to.

Wen recounts the pivotal experiences with health that helped shape who she is today: experiencing poverty and homelessness as a child, becoming a caregiver to her mother who had metastatic breast cancer, and her own struggles with cervical cancer, infertility, and postpartum depression. 

Verywell recently spoke with Wen about her new book and her hopes for the future of public health.

Verywell Health: What made you choose public health as your field of medicine? 

Dr. Wen: I didn't know about the field at all. For as long as I can remember, I wanted to be a physician.

I had severe asthma growing up. I talk in the book about how when I was young, there was a neighbor child who also had asthma who died in front of me because his grandmother was too afraid to call for help. She thought that by calling for help for his medical emergency, their family could be deported because they were undocumented.

So, I had that early experience that propelled me into medicine. I decided to work in emergency medicine because I never wanted to be in a setting where I had to turn away patients because of their inability to pay. 

But it was also in the ER that I saw the limitations of modern medicine. There are so many things that we want to address in our patient’s health that has everything to do with their outcomes but are not things that we can do within the walls of the hospital.

For example, I need to advise my patients who have hypertension, diabetes, and heart disease to eat healthier foods—but what if they live in an area where a grocery store with fresh produce is inaccessible?

What about our children who are coming in with asthma because they live in buildings where people smoke or where there is mold? We can give them steroids and inhalers, but ultimately, we need to help with those living circumstances that are literally causing their illness.

And so, when I had the opportunity to become the health commissioner for the city of Baltimore, it was my dream job. It was an opportunity to impact these social determinants of health by changing policies and implementing measures to deliver direct services that would have a holistic impact on my patients' lives. 

One key change Dr. Wen made as health commissioner for the city of Baltimore was expanding the availability of naloxone, an antidote for opioid overdose, as well as training in administering the drug to all residents in the city, including community outreach workers and police officers. In her book, Dr. Wen says that police culture changed from searching an overdose scene for arrest evidence to determining what drugs were taken, calling an ambulance, and administering naloxone.

Verywell: What role should individuals play in improving their own health? 

Dr. Wen: I talk in the book about how my mother was misdiagnosed and then finally diagnosed with what turned out to be metastatic breast cancer. Then, I became her caregiver while she was going through multiple rounds of chemotherapy, radiation, and surgery. 

I mention this because I also focus on patient advocacy in the book and the importance of people advocating for their own health, understanding that the system that we have isn't perfect. We need to make long-term changes to our system. 

But there are things that people can do to advocate to ensure that they have the best care possible. So, for example, making sure that they bring somebody with them to their doctor's appointment, writing down questions in advance, even rehearsing what they're going to say to their doctor. Those are things that are important in a system where doctors don't have much time with patients. 

In the book, I also talk about my own diagnosis of cervical cancer, how my husband and I struggled with infertility, and my own experience with postpartum depression after my son was born. It took months of me struggling to finally realize that I needed help and overcoming my own stigma around mental health and seeking treatment. 

I talk about it because for many people, we still don't see mental health the same way that we see physical health. And for mothers, we often put everybody else's needs ahead of our own. 

Verywell Health: Did you have to rewrite parts of the book once the pandemic began? 

Dr. Wen: I actually submitted the book in February of 2020—it was written before the pandemic [took hold in the U.S.] and the publisher said, ‘You have to rewrite the book, given that we're now in the middle of the biggest public health crisis of our time.’ That was the right decision because the entire point of the book is about making public health visible. 

And COVID-19 made public health visible in a way that we couldn't have expected any time previously. 

Verywell: How did the pandemic change public health? 

Dr. Wen: One of the things that—even before the crisis—people in public health would say is, you know we're doing our job if you don’t hear from us. If, say, a food poisoning outbreak was prevented, that’s because of all the restaurant inspections that were done.

But public health has always needed more visibility. That's why I wanted to write the book. COVID-19 has laid bare the underlying inequities and disparities that are in our healthcare system and the consequence of underfunding and undervaluing public health. 

Verywell: So, how do we move forward?

Dr. Wen: I am an optimist by nature, although I'm worried that people now equate public health with infection control. That’s an important part of the work, but certainly not all of it.

I really worry that public health has become politicized and is now viewed through a partisan lens. There are legislatures that have already moved to curtail public health powers and authority in a way that I really worry about what might happen for future outbreaks. 

I think we need to change people's perception and their understanding of this field. If what people care about is education or public safety or the economy, we need to make that connection for them and talk about how if you care about a productive workforce, people need to be healthy. Or, if our children are hungry and have untreated mental health and trauma issues, they can't learn in school. We have to make that case. 

People are pulled in so many different directions and we're not addressing chronic issues that are getting worse. The opioid epidemic hasn't gone away. It's gotten worse. The obesity epidemic hasn't gone away. The mental health crisis hasn’t gone away. 

Verywell: Still, you end your book on a note of optimism for the future. Can you tell us a bit more about what makes you hopeful?

Dr. Wen: When we look at this last year and a half, we've seen many examples of people stepping up and doing everything they can. We've seen remarkable scientific collaborations that have resulted in vaccines developed in record time.

We've seen people in communities doing remarkable things to assist one another, to help with food, to assist with housing needs, to stand up testing and mobile vaccinations, and other things that illustrate the dedication and resilience of Americans and people around the world.

This is the opportunity for us to leverage these lessons and not let this crisis go to waste. 

Verywell: What do you think it'll take for us to emerge from the pandemic?

Dr. Wen: I hope that people will start talking about vaccination as a communal societal responsibility. Vaccinations are ultimately our best and only way out of this pandemic. The sooner we can get much higher rates of vaccination, the sooner we can get back to our lives.

I hope that we'll all act as much as we can. For example, if you are a small business owner, consider asking for your employees to all be vaccinated. If you frequent restaurants or gyms, consider talking to the owners about requiring vaccination as something that's important to keep customers and employees and their families safe and to get closer to the end of the pandemic. 

Ultimately, public health is the responsibility of all of us. We are all on the front lines of public health and we all have a role to play here. It’s not somebody else's job—it’s ours. 

By Fran Kritz
Fran Kritz is a freelance healthcare reporter with a focus on consumer health and health policy. She is a former staff writer for Forbes Magazine and U.S. News and World Report.