Member Spotlight: Brenda Fitzgerald
Brenda C. Fitzgerald, MD, is commissioner and state health officer of the Georgia Department of Public Health, the state’s lead agency in preventing disease, promoting better health, and ensuring families have the resources they need to prepare for health emergencies. In addition, Fitzgerald directs the state’s 18 public health districts and 159 county health departments.
What was the experience or motivating factor that compelled you to become a state health officer?
In 2010, I was both privileged and honored to be asked by then-incoming Gov. Nathan Deal to be part of his transition team and, ultimately, to serve as commissioner of public health when the department became a standalone agency in July 2011.
What other positions have you held?
I am a board-certified obstetrician-gynecologist and was in private practice for 30 years before coming to public health. As a major in the U.S. Air Force, I served at the Wurtsmith Air Force Strategic Air Command Base in Michigan and at Andrews Air Force Base in Washington, D.C. I also served as Chairman of the Board for the Georgia Public Policy Foundation.
What is your morning ritual?
I typically hit the ground running by 6 a.m. I start with 30 minutes on the treadmill or around my neighborhood. A little sun salutation yoga and then I’m ready for breakfast—and I love breakfast. A pot of green tea and scrambled eggs with salsa and a slice of avocado are among my favorites. I have an hour-plus drive from home to Atlanta, so, as some of you know, the calls begin from my mobile office, also known as my car. “What time is my ASTHO call? Do we have local transmission of Zika? Am I still speaking at CDC? Can I get an update on Georgia SHAPE for the meeting with our partners? What about WIC? When is the training for Talk With Me Baby? Where is the presentation for early brain development?” And then I arrive at work.
What do you do to stay healthy?
I practice what we preach in public health—I eat healthy foods and I make sure to include physical activity in my schedule every day. Even when my day is jam-packed, I take a step away from my desk or leave a meeting and just walk around the building for a boost of energy, both physical and mental. I laugh a lot, as my team will attest, and I take joy in my work. I also have a loving relationship with Tom, my wonderful husband of 41 years and father of our two beautiful adult children.
What is your favorite vacation spot?
My favorite vacation spot is the south of France—for its wonderful food and wine. Châteauneuf-du-Pape (or “new house of the pope”) is located in the Rhône wine region and produces gloriously rich red wines from a blend of more than a dozen grape varieties. And, of course, one of the many things I love about being commissioner of public health is the opportunity to travel around the great state of Georgia. The mountains, coastline, and beautiful lakes, rivers, and pine forests—our geography is as diverse as our 10 million residents.
Why is health important to you?
That’s simple. Health allows me—and each one of us—to do the things we love. Working, traveling, spending time with family, being a productive member of society—all these things add up to a full and abundant life. My health allows me to perform to the very best of my ability in everything I do.
What are your favorite hobbies?
I love to cook and garden. In some cases, I cook what comes from my garden! There is such a strong connection between a healthy mind and a healthy body. We derive pleasure from our hobbies and that provides mental and physical relaxation. We all need things that help us decompress.
What do you love most about public health work?
When I was in private practice, I saw one patient at a time. Now I get to impact 10 million lives (residents of Georgia) at a time. Public health communicates the importance of healthy lifestyles, educates parents on safe sleep practices for babies, and provides tobacco cessation assistance to entire communities—all at one time! Through the relationships and partnerships we form with other agencies—government, private sector, and academia—our impact can be huge.
What do you find most challenging about public health?
Well-functioning public health departments are central to building healthy populations, but the funding structure to meet that goal is very complicated and fragmented, which presents a constant challenge.
What are your primary public health priorities?
As outlined in both our strategic plan and state health improvement plan, our priorities include: early brain development and language nutrition; reducing the state’s infant mortality and maternal mortality rates; tobacco cessation; eliminating childhood obesity; increasing access to care through our telehealth network; and reducing the burden of cardiac metabolic syndrome, which is a major cause of mortality.
What is your vision for the future of public health?
A strong, capable, and fully functional public health system is essential for this country to have a sufficient and effective healthcare system. Public health does those things that the private sector simply does not, and quite possibly cannot, do. There are three clear examples of this: 1) inspections—food, pools, building sites; 2) disease surveillance and monitoring (e.g., Zika); and 3) responding to emergencies. When Hurricane Matthew hit Georgia, public health coordinated the evacuation of medical facilities and patients from the coast and then provided and staffed shelters. These three fundamental responsibilities of public health—inspections, surveillance, and emergency capacity—must be maintained and strengthened.
In addition, I believe we should increase our capacity in implementation science to bring large-scale improvements to the system. We have large data systems that we can analyze to illuminate patterns so that it becomes clear how the health system should respond. In Georgia, for example, we had a 65 percent incidence rate of elective deliveries before 39 weeks. Our data showed there was an increase in neonatal intensive care admissions, increased antibiotic use, and increased respirator use in these early elective deliveries. By linking birth records with standardized test scores of children in third grade we also showed a significant difference in reading and mathematics scores between 37- and 39-week babies. This information was shared with hospitals, obstetricians, and pediatricians throughout the state, and that information allowed us to quickly reduce our elective delivery incidence rate to three percent. When Medicaid stopped paying for early elective deliveries, the rate dropped even further to just one percent. This change occurred in about two years.
Our future is in using our data and information to quickly inform evidence-based improvements in our medical system.
What is something you are most thankful to have been a part of during your career in public health?
The Ebola virus disease epidemic, in that it relates directly to my vision for the future of public health. Ebola provided us a real-time, real-world model for coordinating efforts among public health and the private sector to achieve optimum health outcomes for individuals and entire communities. In Georgia, the Department of Public Health, CDC, Emory University, Hartsfield-Jackson Atlanta Airport, EMS, law enforcement, hospitals, and many others willingly cooperated to prepare for and respond to Ebola. The work we did together produced a regional (both in and out-of-state) transportation plan for the transfer of patients—with Ebola or any other highly contagious disease—to treatment facilities. This same cooperation lead to the creation of a tiered hospital system in Georgia to care for and treat patients with any infectious disease, some still unknown to us. Equally important was containing the spread of Ebola starting with passengers arriving and departing Atlanta’s airport, an exercise which provided the foundation for a campaign to educate passengers about Zika, ultimately leading to preventing its spread in Georgia and protecting pregnant women and their unborn children.