In May of 2021, when Philadelphia’s previous Public Health Commissioner abruptly resigned, Dr. Cheryl Bettigole was installed as the interim leader of the Department while a search was conducted for a new Commissioner.  She served ably in the role, and in November, Mayor Kenney shifted her status from temporary to permanent.  In honor of Women’s History Month, Impacto Media sat down with Dr. Bettigole to speak with her about her leadership as Commissioner of the city’s Department of Public Health, and her vision for Philadelphia.

Let’s start with your background.  Can you tell us about how you got to where you are today?

I’m a family doctor.  I went into medicine with an interest in taking care of immigrants, particularly in the inner city, and with the goal of improving public health as well as access to high quality affordable care. I did my residency here in town at Jefferson, and then went to work for the city’s health centers.  I was the clinical director at Health Center 6 at 3^rd and Girard for about six years, and then Health Center 10 at Cottman and Bustleton for about 5 years.  During medical school I had spent a summer at a migrant health center in south Jersey, where we served a sizable population of Mexican migrant workers.  I taught myself some Spanish while I was on maternity leave with my first son.  I ended up with a significant group of Spanish-speaking patients at Health Center 6 – from babies to the elderly. It was wonderful to take care of people and get to know them in that setting.  It was also incredibly frustrating, because of all the challenges associated with not having health insurance or being treated poorly by employers. I saw what injustice does to the human body.  I became interested in how to change systems.  I did some writing, public speaking, and testifying about access to care in the days before we had the Affordable Care Act (ACA), with the National Physician’s Alliance (which is now part of Doctor’s for America).  I was active with them doing both national and state-level advocacy, and I eventually joined their board and then later became their President.  I think that balance of both direct service and policy work has given me a sense of the real challenges people face, but also how to solve them at the systems level.  Then, after a three-year stint as the Chief Medical Officer at the same health center where I had spent a summer in medical school, I came back to the Department of Health in 2015.  I was part of the pandemic response team in Philadelphia.  It’s just a weird accident of time that I happen to be the Health Commissioner of Philadelphia right now, but I’m trying to get everything I possibly can done while I’m in this role. 

You came into this role during a strange time, in the midst of Covid-19.  What wins have we had during the pandemic?

Two big wins come to mind.  One of them is a story about Esperanza, as a critical force in vaccination of Latinos.  Early on, vaccination rates for Latinos were very low.  I got to know Reverend Luis Cortes because he called me multiple times and said, “We need doses in the community.”  Largely through his advocacy, we were able to locate a FEMA-supported clinic in the neighborhood.  Then, Quetcy Lozada and the community outreach team at Esperanza did unbelievable work getting community members signed up.  We saw a tipping point in the data – at first, people are afraid, but eventually they know enough people who have gotten vaccinated, and they feel more comfortable. And you see the curve soar.  If you look at the graphs – they’re at www.phila.gov/covid – you can see in April 2021, the graph of Latino vaccination in Philadelphia took off, and has stayed very high.  It’s higher than almost every other group.  Early in the pandemic, when we looked at case rates, hospitalizations and deaths, the highest death rate was among elderly Latinos. But that did not remain true over time.  When you look at subsequent waves, Latinos have a much lower hospitalization and death rate, and I believe it’s the high vaccination rate coming into play. It’s a really positive story. The other win is that Philadelphians have been much more willing to wear masks than people in any other city.  We call ourselves the City of Brotherly Love and Sisterly Affection, and we did that for each other.   

What’s the advice you would give to the average person about how to continue to deal with this? What do we do next?

The tricky thing is, it’s not over, it’s just better.  We still need to maximize protection.  We’re not seeing boosters in the Latino community.  I think people are thinking, “Okay, I did what I had to.” But the boosters make a massive difference.  Also, we’ve talked throughout the pandemic about managing risk, and that’s more important than ever.  If you’re going to a crowded place, you don’t lose anything by wearing a mask. We do want to get back to social connectedness, and we’re at a stage where that feels safer.  But we can continue to be cautious.  We should be aiming for those high-yield social interactions that matter the most to us – not wasting our “risk budget,” in a sense. 

What advice would you give to our readers about how they can live healthier lives, and advocate for themselves in the best possible way? 

I would give systems answers to that question.  The first thing that comes to mind is voting.  We talk a lot about health as if it’s about making good and bad choices.  But if you look at who’s healthy and who’s not, it’s about systems, poverty, education, jobs, and justice.  Those are the things that really influence health.  Vote, and make sure everyone in your life votes.  The other thing is civic engagement.  Calling legislators and showing up to testify at hearings is something very few people actually do.  It makes a big difference when people learn about the issues that matter to them, and talk to their legislators at the local, state and federal levels.  There’s a lot more I could say, but I focus on systems – especially because everything else tends to make people feel bad and implies that if you’re not healthy it’s because you’ve made bad choices, which is not the case for most people.  Of course, we should all take good care of ourselves, but the systems’ problems make the most difference.

How can communities get involved with the Department of Health?

There are a lot of things we’re working on. We are thinking a lot about environmental justice and the ways that impacts health – people can get involved in that.  We also want to equip people to support their families, friends, and neighborhoods in the opioid crisis.  We’re losing more than 1200 people a year, and we want to develop training for community members to intervene.  Another priority is primary care access and making sure everybody in Philadelphia has a primary care doctor, even if they don’t have health insurance. We’ll be reaching out to communities on all of these issues and more.