The doctor-turned–policy leader—and now chief health officer at Google—is overseeing the tools and technology that could help make health care accessible to all. 

Health-Print-Nov-2021-Wellness-Warriors-Karen-DeSalvo

What made you want to become a doctor and work in the public health sector?

When I was about 13, I was doing a book report for a science class on radiation therapy, because my mom worked in a doctor's office. So, I went in and shadowed, and I was like, "This is pretty great. It's combining things I love, science and helping people, and I think I'll be a doctor." And it worked out really well because I was able to make it to medical school and got a Masters in Public Health at the same time. I practiced medicine for 20 years. 

What led you to become the New Orleans health commissioner?

When Katrina happened in 2005, I was on the faculty at Tulane University School of Medicine. I was doing research, teaching, and seeing patients. But when the storm happened and we flooded, everything shut down, and it caused a moment of reflection, which sounds way too simple. But it caused a sort of "What's my reason for being here?" And I realized that I needed to lay aside some of the things I was doing, like research, to help stand up a new health care system, one that was more focused on preventive care and community health. My work for the first seven or so years after the hurricane was focused on building up strong primary care. Then you start to learn that, yes, quality primary care really matters, but if someone has diabetes, for example, and I want to prescribe them insulin, if they don't have electricity in their house to keep that insulin cold, or if they don't have a house, it doesn't matter how good the quality of primary care is that I would deliver. So when I was asked to be the health commissioner for the city of New Orleans, I saw it as a way that I could step in and address those big systemic factors that were affecting my patients, and I did through partnerships like FitNOLA, a multipronged program addressing physical, emotional, and social well-being. 

So what's your current role like as chief health officer at Google?

I joined the company right before the COVID pandemic took the world stage. So my day-to-day job is making sure that Googlers are taken care of—first that meant figuring how to get out of the office, and now, how can we get back into the office safely due to the pandemic. But it's also to help develop and provide tools to the public health community so they can do their jobs more effectively to support all of us. 

You've been a part of several new tool launches since working at Google. Which do you think were or are going to be most impactful?

The Community Mobility Reports, which monitored at the height of COVID if people were staying away from grocery stores, retail spaces, and workplaces, as stay-at-home orders were in place. We also partnered with the Satcher Health Leadership Institute at Morehouse School of Medicine to develop a Health Equity Tracker that gives insight into how COVID is disproportionately impacting Black, Latinx, and other communities of color. And non-COVID-related, we're working on a dermatology AI tool to help consumers narrow down a list of potential skin conditions that they might have. It's still in the  development phase. The origin of it comes from one of the doctors on our team who had a patient with a skin condition that was further along because the person hadn't had access to a dermatologist. We recognize the importance of technology and how it has the potential to significantly democratize access to quality care. For this tool, it means ensuring it is inclusive and can work for all skin types. 

How has your work changed the way you view the world?

I learned really early that people are carrying a lot in their hearts and minds. When you close that exam room door and it's the two of you, people tell you things they've never told anyone, ever. They have layers, and we all have to be open and kind. The public health piece of it has taught me that systemic and structural things have affected many of my patients. There's a constant toggle in my brain now that there's a person but they're in a system. What do we need to do to change the system? 

This article originally appeared in the November 2021 issue of Health Magazine. Click here to subscribe today!

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