Member Spotlight: Karyl Rattay

March 30, 2017 | ASTHO Staff

Karyl Rattay, MD, is director of the Delaware Division of Public Health. As director, she leads nearly 700 employees who promote health, reduce health inequities, and protect Delawareans from disease, environmental hazards, and public health emergencies. The division’s vision is healthy people in healthy communities. The Delaware Division of Public Health became a nationally accredited public health agency in 2016.

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

After five years of private pediatric practice, I shifted my career and obtained a master’s degree in epidemiology and completed a preventive medicine residency. During that time, my eyes were opened to the role that broader system and policy changes can have on the determinants of health and health outcomes. Eight years ago, after leading a childhood obesity initiative at Nemours Health & Prevention Services for five years, I was approached for the state health official position. By this time in my career, it was clear to me that serving as a state health official would provide tremendous opportunities to improve the health of our citizens. I was offered the position and began in May 2009.

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

No one person influenced me to lead a health department. As I became more familiar with the role, I realized my prior experiences, education, and collaborative personality made me a good fit to serve as the state health official. I embraced this opportunity, seeing it as pivotal for improving the health of a statewide population.

What is your morning ritual?

I rise at 5:30 a.m., turn on the Keurig, and go for a walk with our dog Rigby. After reading the paper and preparing myself mentally for the day, I wake our two children at 7:00 a.m. I make sure their lunches are packed so we can grab them easily. Once everyone eats a healthy breakfast, I drop the kids off at the bus stop before driving to work. 

What do you do to stay healthy?

I work out at least four times a week. I enjoy distance running, yoga, and pilates. I drink mainly green tea and water, avoiding alcohol and sugary beverages and foods except for an occasional sweet. I eat a lot of salads, vegetables, poultry, fish, and whole grains. I try to remain stress-free by getting at least six hours of sleep a night, diligently abiding by my workout routine, remaining as organized as possible, and keeping a good sense of humor.  

Where is your favorite vacation spot?

My family recently found a quiet spot on the eastern side of Grand Cayman. It is beautiful, tranquil, and restful with an abundance of water sport opportunities. My family enjoys snorkeling, swimming with stingrays, and walking around barefoot for a week.

What are your favorite hobbies?

As a working mother, my current hobbies are largely limited to cheering on my kids at their soccer games, gymnastics meets, driving them to practices, and helping them with their homework. I really enjoy these activities! However, I also love distance running and having my own quiet time to read, listen to music, or solve jigsaw puzzles.

How did your career in public health begin?

I was in pediatric practice in the late 1990s when I realized I wanted to focus on prevention. I was really struck by the rapid increase in overweight and obesity among youth while passionate about healthy eating and physical activity. I didn’t have the tools I felt I needed to help families improve their lifestyles. So I completed a preventive medicine residency at the University of Maryland and earned a masters in epidemiology. This experience introduced me to the power of public health. It helped me realize the importance of population health and the impact of policies and broader practice and programmatic changes. It also helped me to understand health equity and the role that social factors have on the health of individuals and populations. I realized that if we could not change the environments in which people spend their time, we would be ineffective in improving health behaviors. I focused a lot of my early efforts on taking a comprehensive multisector public health approach to supporting physical activity, healthier eating, and obesity prevention.

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

I am passionate about the mission to promote and protect the health of Delaware citizens. There’s not a day that goes by when I don’t feel driven to improve the lives of our citizens, especially when it comes to improving outcomes for children! Kids are where the greatest prevention opportunities exist. This includes women having children when they are ready, supporting healthy pregnancies, and working toward improved environments for children so they can grow up healthy.

What do you find most challenging about public health?

One of the greatest challenges in public health is to effectively convey prevention in a meaningful way. In other words, we consistently need to help those making policy and budgetary decisions realize that prevention efforts may not get us returns on investment in one budget year. It may take several years, but these are ultimately the best levers to improve health. It is imperative that we work upstream to address preventable determinants of health. This includes an emphasis on addressing health inequities and helping decisionmakers understand that the systems we’ve developed and the policies we have put in place don’t always treat people fairly, and this impacts health. The challenge here is to help others see that certain populations need more support than others.

What are your primary public health priorities?

I’ve been in this role for eight years, and one of our greatest accomplishments was becoming accredited in 2016. The Delaware Division of Public Health has evolved and improved to better meet the needs of Delaware’s growing and diverse population by emphasizing population-based activities as our core services, and working to strengthen our community-based public health system.

Like every other state, at the top of our priority list is addressing the opioid crisis and preventing addiction. This is a relatively new priority for us. In addition, the Division of Public Health identified four other strategic priorities that guide our work. They are:

1. Improving health-related lifestyles by reducing obesity.
2. Improving access to quality and safe health care by implementing health reform.
3. Achieving health equity by improving the health of minority populations.
4. Improving performance by implementing a performance management system and improving organizational culture.

What is your vision for the future of public health?

Our vision is healthy people in healthy communities. I personally embrace this vision and see it as fitting for the full public health system. That means for governmental public health as well as our traditional and non-traditional partners. My hope is that public health is viewed as a valued partner, with the recognition that maintaining a strong infrastructure will take us into the future to best promote health and prevent chronic physical and mental health conditions while protecting individuals in all of the environments in which they spend their time.