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Exit interview: NYC's health commissioner reflects on his tenure in the Adams administration
By
Elizabeth Shwe
and
Sean Carlson
Published Oct 19, 2024
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Leigh Vogel/Getty Images for Concordia Summit
By
Elizabeth Shwe
and
Sean Carlson
Published Oct 19, 2024
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New York City's Health Commissioner Dr. Ashwin Vasan is stepping down a few months earlier than his original plan to leave in December. He's been health commissioner since Mayor Eric Adams took office in 2022 and led the city through part of the COVID-19 pandemic and other public health emergencies.
He joined Sean Carlson, host of WNYC’s "All Things Considered," to discuss his tenure at the helm of one the biggest municipal health agencies in the world.
Sean Carlson: Doctor, can you talk about what led you to decide to leave your position earlier than previously announced?
Dr. Ashwin Vasan: It's really an expression of two things. One is a genuine pull towards my family. Your family serves with you in these jobs and these jobs can be all-consuming.
I have three small kids who have missed me for three years. And I have a wife with her own career and who has her own dreams and ambitions. And we talk a lot about gender equity and co-parenting, but you have to make that a reality at some point. The second piece is really, I feel very confident in and proud of the leadership team here that I helped build.
And that has been here. The 7,000 staff that come every single day to serve the city without any plaudits or attention. Now we have interim commissioner in Dr. Michelle Morris, who I have a lot of belief in and confidence that she will keep us running the same race towards healthier, longer lives.
We'd be remiss if we didn't mention that your announcement that you'd be resigning came last month amid multiple federal investigations and a wave of departures of top city officials in the administration. Can you explain that timing?
You know, I'm not blind to what's going on around me. OK. I'm a New Yorker first and nobody likes to see this kind of environment, but that is not what's driving this. This is really a pull towards my family and a confidence in my team to continue the fantastic public health work that we've started over the last three years.
What is one of the most memorable moments during your three-year tenure as New York City's health commissioner?
Oh, goodness. You know, HealthyNYC has really punched in the GPS coordinates for a long-term health agenda. That will live long beyond us. We passed it into local law and that will live beyond this administration. We stood up after [the Supreme Court decision in] Dobbs in 2022, just months after I started and became a national leader in abortion access, becoming the first city to give free abortion medication at our clinics and by telehealth and launching the abortion access hub. That’s the first government hotline that connects people with abortion services, procedures, and supports and that has served over 5,000 women, 25% of whom are coming from restrictive states. But, you know, my tenure started at a very interesting time when we were coming into Omicron and then out of the worst of COVID. And what I saw was the release of a lot of anguish and fear and sometimes anger after the two years of the worst of COVID. And that came right to my doorstep. You know, I had protesters at my home and scaring my kids. And so that was probably the biggest surprise is just how much pent up pain and trauma and anger there was and maybe still is at times, given how polarized we are.
You focused on adolescent mental health as the city's health commissioner, like launching a tele-mental-health service for New York City teenagers that's called Teen Space. Can you tell us more about how that's going?
Extraordinarily well. There — by the end of the year — will be 20,000 New York City teens on therapy that weren't getting it a year ago. That’s all because we took a risk and leaned into technology and meeting kids where they are — not something that government always does easily or well. 65% of those kids are [Black, indigenous and people of color] teens, and almost 70% of them are saying they're experiencing some improvement. This is data based on September 2024.
So what's also exciting about that is it's not just kids with diagnosed or self-reported mental health challenges. But there's also kids saying, “I just want to be my best self,” or “I want to navigate my school social situations,” or “I'm having relationship troubles.” They need to not only know when to ask for help and how to ask for help, but to get it when they ask.
According to recent city data, overdose deaths are down among some groups in New York City. At the same time, the hardest hit communities have seen little progress. So can you tell us more about what you think led to lower overdose deaths, and what more needs to be done?
So much more to be done, but I'll also say that our overdose prevention centers work. You know, I know we have the only two in the country run by a nonprofit group, OnPoint, and most overdoses happen alone. They happen in isolation, not on the street or not in public spaces, but they're actually happening in people's homes.
We need to bring that use out of the shadows and into safe places where not only can overdoses be intervened on, but also where we can refer people into treatment and into mental health care. And we're seeing more naloxone means lower overdose deaths. So we've given out as a city over 300,000 kits each year, but you rightfully point out that there are deep and abiding inequities here. Black and Latino New Yorkers, particularly middle-aged men, are almost twice as likely to experience a fatal overdose than white men, and we need to really lean into approaches that are place-based, meaning our resources need to go to the neighborhoods and the ZIP codes where people are being affected the most.
And that's exactly what we're doing with, for example, our opioid settlement funds that we've gotten from the state, we're putting those exactly in the neighborhoods where they're needed the most.
Doctor, what's one of the hardest parts about your job that you feel like most New Yorkers probably don't know about the city's health department?
Health is a team sport and the health department can't deliver on health alone. Health requires that our health care systems are pulling alongside us. Our nonprofits are working in partnership with us. They require that philanthropy and the private sector are also aligned and they require that we're working not duplicatively or redundantly or at cross purposes, but actually in a very clear flying formation towards health.
And what we saw during COVID was teamwork. We saw a lot of alignment and partnerships with emergency funding to combat a single common enemy in covid. I think the hardest part of the job is being able to articulate that and also not being entirely responsible for all the levers there. You know, I'm not the housing authority.
I'm not the police department. All I can do is align and cajole and persuade and try to get other leaders in the city bought into the fact that there are too many people dying that are easily preventable.
There have been concerns about the mayor's ability to retain and attract top talent. Do you have any thoughts on that?
I'm so focused on the talent we have at the agency. I've been able to recruit leaders from all across the city and all across this country to come in and work on health. And this health department has been around for 200 years. It's work has had impact all across the city, all across this country, whether you look at tobacco control or TB or vaccination, and that's because we're in New York City and we're full of passionate, talented people who come to this department to work for the city.
And that will continue regardless of who's in charge.
Let's talk about what your plans are. What is next for you?
I'll be going back to my faculty position at Columbia in the short term, but in the coming days and weeks, I'll be paying very close attention to November and trying to do my level best to participate in our democracy.
And then after that, we'll see what unfolds. I love public service. I'd be honored to be in public service again.
Tagged
new york city
Mayor Eric Adams
Politics
Health and Science
Elizabeth Shwe
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Sean Carlson
Before coming to New York Public Radio, Sean worked in print, online and radio news around the mid-Atlantic region and Alaska. A New Jersey native, he holds a B.A. from the New School University in Greenwich Village and an M.A. from the Craig Newmark Graduate School of Journalism.
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Gothamist is funded by sponsors and member donations
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