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New county health chief sees some goals as universal

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 martin.espinoza@pressdemocrat.com.





17 Responses to “New county health chief sees some goals as universal”

  1. MOCKINGBIRD says:

    Snarky-you are apparently unaware of the fact that Sonoma County DHS (department of health services)directly work with the schools on health and dental issues. It’s been like that forever. COUNTY EMPLOYEES.

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  2. Snarky says:

    Mockingbird:

    Children in public school are already required to pass Health Education classes in their classwork.

    Young people in California public colleges are offered classes in nutrition and diet.

    THAT is where we learn good dietary habits in addition to anything that we learned from our own parents.

    We don’t need a $230,000 “Health Chief” repeating what is already common knowledge. Especially a “Chief” who, apparently, rides a bike in un-safe shoes.

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  3. MOCKINGBIRD says:

    No one needs to be told what to do if they already know what to do. It seems the worst offenders and the biggest complainers are the ones costing the rest of us our tax money when they get sick from eating garbage their whole lives and not getting off the couch enough. DHS, Department of Health Services, doesn’t TELL YOU WHAT TO DO. It’s there to TEACH YOU, offer advice and resources to get and stay healthy. If you chose to be unteachable then I resent my tax dollars going to your ER visit. I resent my insurance premiums going up because you use too much of yours.

    Go ahead and eat that fried twinkie at the fair. It does contain transfat, but maybe it’s fried in canola oil. Afterall, unless you do it at home everyday, it’s only once a year and that won’t kill you.

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  4. Annie Erving says:

    I see lots of GOOD that can come of this, let us give her a chance. I recently interviewed with Health Services, OUR Sonoma County is way ahead of the pack.

    Why not see the GOOD…………..I am thrilled as county employee that it looks like something great CAN HAPPEN.

    As the public, may not see we need HEALTH CARE FOR ALL.

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  5. Jerry says:

    have any of you looked around santa rosa or maybe in a mirror lately, there are a lot of people that need help getting of the computer and away from the table and TV for a nice bike ride and learn how to eat healthy

    Thumb up 7 Thumb down 1

  6. Grapevines says:

    Anyone want to join me at the fair for “deep fried Twinkies?” before the food nazi’s announce that this is a “non-trans-fat day!”

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  7. Judy D says:

    This is nothing but another government bureaucrat out to tell us bumpkins how to eat, live and enjoy life.

    This has been going on in New York for years and now our beloved county politicians have added a mouth piece for the “correct way to eat and live” to their agenda of social advancement.

    The county and the new eating and living bureaucrat need to take their message back to those on the East Coast who need it and leave us vegans and our smokeless workplaces alone to suffer in silence.

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  8. clarification says:

    Was she hired by the county administrator and the chair of the board to replace Director Scardaci in the near future?

    Will her duties also include overseeng the troubled shelter?

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  9. Heather says:

    Great, another radical leftist, that is all this county needs.

    Thumb up 18 Thumb down 5

  10. Commonsense says:

    “..a citywide ban on trans fat…” Really, so now we need a agency from government to tell us what to eat and not to eat? I’m all for educating people on how best to care for themselves, but that is where it should stop, and frankly that really isn’t the core priority of government in IMHO, but when we let public agencies tell us what we can and cannot eat or drink, then we’ve gone from a republic focused on individual freedom and opportunity to pursue our own life and idea of happiness to being followers of the government decided norm. Sad and frustrating, I think I’m going to have to indulge in some trans fat to feel better.

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  11. susan says:

    WOW!!! 202,555 to try to tell people how to eat? What a gross waste of tax payers money. Of all the health info we have and America gets fatter and fatter. She better not try to take our buffets away.

    Thumb up 24 Thumb down 4

  12. susan says:

    I wonder if she was riding the bike in that outfit?

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  13. Snarky says:

    I am more than a little curious if it was the Press Democrat staff who dreamed up this posed photo op?

    Notice her shoes? HARDLY safe riding attire.

    So much for thinking like a “Chief.”

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  14. Sheri Cardo says:

    This is a world-class hire. How exciting for Sonoma County to have captured someone of her caliber and ingenuity!

    Thumb up 10 Thumb down 27

  15. Over Easy says:

    Her specialty is developing rules and laws to govern your lifestyle all under the guises of being healthy and saving money through lowering risk factors.

    It is purely another example of the inept leadership of our county. The old do as I say not as I do. A picture is worth a thousand words.

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  16. Skippy says:

    Fabulous!
    A radical Liberal social activist will be bringing the bludgeon of Big Govt to our quaint province to “educate” us.
    As stupid hicks, we should thank this busybody nanny?
    No thanks.
    Be prepared to be profoundly ignored, Ms Chalfin.
    With luck we can pay her exorbitant pension forever.

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  17. Snarky says:

    The absolute best, most effective “health chief,” is yourself.

    It doesn’t take a government bureaucrat to take care of your body.

    By exercising, eating fruits and veggies, and avoiding chemicals like booze and drugs, your body will reward you will a lifetime of good living.

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