New York City Health Commissioner Dr. Ashwin Vasan is resigning several months earlier than originally planned to step down in December. He has served as health commissioner since Mayor Eric Adams took over in 2022, leading the city through some of the COVID-19 pandemic and other public health emergencies.
He joined WNYC’s “All Things Thought” host Sean Carlson to talk about his tenure at the helm of one of the world’s largest municipal health agencies.
Sean Carlson: Sir, can you talk about what led to your decision to leave your position earlier than previously announced?
Dr. Ashwin Vasan: It actually expresses two things. One is a genuine fascination with family. Your family is helping with these jobs, and these jobs can be all-consuming.
I have three small children and they have missed me for three years. And I have a wife with her own career and her own dreams and ambitions. We talk a lot about gender equality and co-parenting, but it has to become a reality at some point. The second part is I’m very confident and proud of the leadership team here that I helped build.
And it was here. Our 7,000 staff come every day and serve the city without any praise or attention. We currently have Dr. Michelle Morris as interim commissioner. I have great faith in her and am confident that she will continue to run the same race as us towards a healthier and longer life.
We would be remiss if we didn’t mention that your announcement to resign last month came amid multiple federal investigations and a flurry of resignations from top city officials. Could you explain the timing?
You know, I’m not blind to what’s happening around me. got it. I’m a New Yorker to begin with and no one likes to see an environment like this, but that’s not what’s causing this situation. This really appealed to my family and gave me confidence in my team to continue the great public health work we have started over the past three years.
What is your most memorable moment during your three-year tenure as New York City Health Commissioner?
Oh, good. As you know, HealthyNYC has really introduced GPS coordinates for long-term health challenges. It will outlive us. We enacted this as a local law, and this law will outlive this administration. Dobbs (Supreme Court decision) in 2022, we stood up and I became the first national leader in abortion access, providing free abortion pills in clinics and telemedicine, and launching the Abortion Access Hub. It became a city. . It is the first government hotline to connect people with abortion services, procedures and support, and has served more than 5,000 women to date, 25% of whom are from states with regulations. But as you know, my tenure started at a very interesting time, as we were entering Omicron and then coming out of the worst of COVID-19. And what I saw was a lot of anguish, fear, and sometimes anger being released after two years of the worst of the coronavirus pandemic. And then it came right in front of me. You know, there were protesters in my house and they were scaring my children. And perhaps the biggest surprise, given how polarized we are, is how much pain, trauma, and anger there was, and perhaps still is, at times.
As New York City’s health commissioner, you focused on youth mental health, including launching a telemental health service for New York City teens called Teen Space. Can you tell us more about the situation?
It’s going very well. By the end of the year, 20,000 New York City teens will be in therapy who were not receiving treatment a year ago. It’s all because we took a risk and leaned into technology to meet our kids where they were. It’s not something governments always do easily or well. 65% of those children are teenagers (Black, Indigenous, people of color), and almost 70% of them say they are experiencing some improvement. Data as of September 2024.
What’s even more interesting is that it’s not just children who have been diagnosed or self-reported to have a mental health problem. However, some children say they want to be the best version of themselves, want to survive social situations at school, or have relationship problems. Not only do they need to know when to ask for help and how to ask for help, but they need to know that when they ask for help, they will get it.
Overdose deaths are decreasing for some groups in New York City, according to recent city data. At the same time, little progress has been made in the hardest-hit communities. So can you tell us more about what you think has led to the reduction in overdose deaths and what more needs to be done?
There is a lot of work to do, but I also want to say that our overdose prevention centers are working. As you know, OnPoint, a nonprofit organization, operates only two facilities in the country, but most overdoses occur alone. They occur in isolation, not on the streets or in public places, but actually in people’s homes.
We need to bring its use out of the shadows and into safe spaces where we can not only intervene in overdoses, but also refer people to treatment and mental health care. And more naloxone means fewer overdose deaths. So while we as a city have distributed more than 300,000 kits each year, it’s no surprise that there are deep-seated inequalities here. Black and Latino New Yorkers, especially middle-aged men, are nearly twice as likely to experience a fatal overdose compared to white men, and we need to take a place-based approach seriously. Postal codes where people are most affected.
And that’s exactly what we’re doing. For example, we are directing the opioid settlement funds we receive from the state to precisely where they are needed most.
Sir, what is one of the most difficult things about your job and something that you think most New Yorkers probably don’t know about the city’s health department?
Health is a team sport and health departments cannot achieve health alone. To stay healthy, we need our health care system to work with us. Our nonprofits are working collaboratively with us. Philanthropy and the private sector are also being asked to work together so that we don’t overlap, overlap or cross objectives, but actually form very clear flight lines towards health. You are required to work on it.
And what we saw during the coronavirus pandemic was teamwork. We have seen many collaborations and partnerships with emergency funds to fight a single common enemy in COVID-19. I think the hardest part of this job is being able to articulate that and not having full responsibility for all the levers that are there. You know, I’m not the Housing Authority.
I’m not a police officer. All I can do is align myself with other leaders in the city, appease and persuade them to understand that there are far too many deaths that are easily preventable.
There were concerns about the mayor’s ability to retain and attract top talent. Any thoughts on that?
I really pay attention to agency talent. I was able to recruit health leaders from across the city and across the country. And this health department has been around for 200 years. Its work has had an impact across the city and country, including on tobacco control, tuberculosis, and vaccination. That’s because we’re in New York City and there are a lot of passionate and talented people who are participating in this movement. A department that works for the city.
And that will continue no matter who is in charge.
Let’s talk about your plans. What’s next?
Although I plan to return to my faculty position at Columbia University in the short term, I will be paying close attention to November in the coming days and weeks and doing my best at my level to participate in our democracy.
And then let’s see what happens. I love public service. I am honored to be involved in public service again.
