By MARTIN ESPINOZA
THE PRESS DEMOCRAT
Sonoma County should expect big things from its new public health officer, Dr. Lynn Silver Chalfin.
She comes from New York City, where as assistant health commissioner she helped launch initiatives that affected the lives of millions of people and established national trends, from a citywide ban on trans fats to a law requiring fast food calorie labeling.
While New York and Sonoma County are in many ways worlds apart, Silver Chalfin said the public health goals for both communities are much the same: tackling obesity and smoking, increasing access to quality care and creating an environment that encourages healthier lifestyles.
“The things that kill the most people, preventably, across the United States and Sonoma County are still tobacco and obesity,” she said. “Those are things that we need to continue to address in Sonoma County.”
She will tackle that challenge while overseeing about 40 people working in areas of disease control, emergency medical services, clinical services and health hazard responses.
As public health officer, “she’s setting the agenda for what are the priorities for our community … what are the issues we want to tackle as a community,” said Naomi Fuchs, executive director of Santa Rosa Community Health Centers.
Silver Chalfin, 54, took over the county’s top public health post from Dr. Mark Netherda, who was serving as interim health officer following the retirement of Dr. Mary Maddux-Gonzalez in mid-2011.
She has been working on a part-time basis for the past few months and will become full time by mid-August. Her compensation, including benefits, is $202,555 a year.
Silver Chalfin grew up in New York City and attended Hunter College High School, where U.S. Supreme Court Justice Elena Kagan was a year behind her. She studied biology and physiology at UC Santa Barbara.
She then attended Johns Hopkins University, where she received a joint M.D. and master of public health degree and trained in international health and pediatrics. During her studies, she took a year off and worked in Nicaragua.
Silver Chalfin knew her trajectory would lead her to the public health arena.
“I had always been a political and social activist from the time I was very young,” she said. “I had worked on a number of issues, including human rights in Latin America, reproductive rights.” Early on she had “a feeling that I would want to try and look for that interface between medicine and social issues — social change.”
Before working in New York, she spent 15 years as a professor teaching public health in Brazil, where she met her first husband and where her daughters were born.
She and her new husband, Dr. Donald Chalfin, a critical care physician and health economist, married about a year ago and the couple decided to move to Northern California for climate.
As New York’s assistant health commissioner, she was in charge of programs aimed at preventing chronic disease, including diabetes, cancer and heart disease.
While traditional public health initiatives attempt to change individual behavior, Silver Chalfin sought a newer approach that focused on creating healthier environments.
“Most of the determinants that cause people to become obese or to smoke, to eat unhealthily or even to develop many respiratory illnesses are due to environmental factors to the way our society has organized how we eat, how we breathe, how we move through our day,” she said. “So I really try to focus on developing environmental change approaches to preventing chronic disease.”
In New York, she helped push for a ban on artery-hardening trans fats in food establishments, the first such initiative in the nation. According to a July 17 article in the Annals of Internal Medicine that Silver Chalfin helped author, the trans fat ban has resulted in an 83 percent reduction in trans fat in foods sold at restaurants and similar outlets.
Also in 2007, the city adopted a law requiring calorie labeling at fast food restaurants, a move that subsequently spread across the country and was incorporated into President Barack Obama’s health care overhaul.
She also helped write guidelines for food procurement by public agencies, including schools and jails, that affected 260 million meals a year.
Another change she helped oversee was the creation of the New York City Active Design Guidelines, a 2010 initiative that seeks to redirect building and public space design in ways that promote physical activity.
One example, she said, was resurrecting the grand staircase, an architectural element that fell out of fashion as elevators became more prominent.
“We’ve basically designed physical activity out of our environment in large part, so we need to figure out how do you design it back in in ways that are aesthetic and pleasant for people,” she said.
Fuchs, the community health centers director, said Silver Chalfin’s “experience in New York will be a tremendous asset to our community.”
The new county public health director said that about half the money Americans spend on food is spent eating out, a habit that constitutes a third of our meals. But making the food we eat outside the home less lethal is only part of the solution, Silver Chalfin said.
It’s going to take a “slower and diligent effort to assure that we don’t lose the culture of cooking,” she said.
Her immediate plans for Sonoma County do not include any big shake-up in her department. Silver Chalfin said she’s currently in a “listening” mode, trying to learn as much as she can about the community.
She will be collaborating with agencies including the county agricultural commissioner, community health centers and hospitals, said county Director of Health Services Rita Scardacci, to whom Silver Chalfin reports.
The county is replete with outdoor resources that are ideal for active and health-conscious residents. Even so, the community is hindered by a motor-vehicle culture that conflicts with mass transportation and efforts to encourage cycling and walking, she said.
A number of neighborhoods still don’t have sidewalks, she said.
“On the one hand, it’s easier to be outdoors; on the other hand, California is a much more car-centered society where most people move about in cars,” she said.
She initially thought that once she arrived in Sonoma County she would launch on issues she’d been working on in New York. But she has begun seeing that there were issues she hadn’t expected, such as lack of dental care for children and the fact that the water supply is not fluoridated.
In New York, the state’s version of Medicaid is more generous than it is in California, where dental services are limited, particularly for adults.
“I hope that eventually water fluoridation could decrease the rate of tooth decay, which is very high in our children, particularly low-income children,” she said.
She hopes that full implementation of Obama’s health care law in 2014 will alleviate some of the problems Americans have in accessing health care, especially specialty medical care.
But a much more aggressive overhaul of the health care industry is needed, she said, adding that universal health care is a goal for the future.
“But right now, I think we have to work together as a community and try and pull together the different providers in the community to improve access,” she said.
You can reach Staff Writer Martin Espinoza at 521-5213 or firstname.lastname@example.org.