Wednesday, February 23, 2011

Weighing in on the crib safety debate

Today I submitted the following letter to the editor of the Baltimore Sun:

A study released last week in the medical journal Pediatrics and reported on the Sun’s website Thursday noted alarming rates of injuries to children age 2 and under in cribs, playpens and bassinets.

This could give the wrong impression that cribs are not safe and should not be used. To the contrary, a properly assembled crib is the safest place to put a baby to sleep. However, as the article stated, two-thirds of these injuries involved falls. In 2008, 27 infants in Baltimore City did not reach their first birthday because they were put to bed in unsafe sleeping environments. These are highly preventable deaths.

Baltimore’s B’more for Healthy Babies campaign is helping lower the city’s stubbornly high infant mortality rate by educating parents and caregivers about the ABCs of safe sleep – Alone, on his or her Back, and in a Crib – every time, no exceptions.

Let’s hope the federal government’s ban on the sale of drop-side cribs, which starts in June, significantly reduces the number of young children injured in falls. But by placing infants to sleep in a safe environment, alone and on the back, in a crib, without any pillows, blankets or toys, we can save many lives - starting today.

Tuesday, February 22, 2011

Ending drug addiction in Baltimore, one case at a time

Last Friday, I had the privilege of giving the keynote address at a ceremony to honor graduates of the Baltimore City Felony Drug Diversion Initiative (FDI). The FDI program is part of Baltimore’s innovative drug court system, which seeks to identify offenders with substance abuse addiction and guide them into treatment programs. Started in 2003, FDI offers felony offenders with drug problems the option of entering substance abuse treatment as an alternative to incarceration. This program is a true Baltimore success story, reducing recidivism rates while saving money, and has been hailed as a model for drug court programs that could be replicated around the world.

This initiative was born out of a terrible tragedy. On October 16, 2002, seven members of the Dawson family lost their lives to a senseless act of drug-related arson. Federal, state, and city elected officials, members of the clergy, and the public were enraged and demanded action. In the six years since its implementation, the Felony Drug Diversion Initiative has served close to 340 city residents, many of whom are from the Oliver community where the Dawson family tragedy occurred.

While at the ceremony, I flashed back to my days as a primary care pediatrician in the Columbia Heights section of Washington, DC. Ten years later and I will never forget Ms P – a woman in her mid-forties who looked older than her years due to drug use and incarceration. She had recently been released, was in recovery and was getting her life together. Part of getting it together was bringing her daughter to the doctor’s office for a regular check up. 

Over the course of about 3 years, I saw her and her daughter on a regular basis. It was through that relationship that I came to learn the important role we all play in supporting individuals through recovery. It was also where I learned that, in order to be successful in the fight against addiction, we need to tackle it from multiple approaches. 

Baltimore faces many public health challenges, and substance abuse is chief among them. The Health Department estimates that 63,000 people in Baltimore City have an alcohol and/or drug problem that necessitates treatment.

In my view, the Felony Drug Diversion Initiative demonstrates how a comprehensive public health approach can be used to break the cycle of addiction and really improve people’s lives. As an alternative to incarceration, FDI clients presenting with substance use disorders are required to make a long-term commitment of at least 18-months to seek help for a drug and/or alcohol addiction. Today’s graduates had overcome the hurdles of recovery and successfully completed their substance abuse treatment programs.

Life rarely grants us second chances. That’s why it was truly inspiring to see and hear stories of these graduates who, when given a second chance, seized the opportunity to change the course of their lives. Their achievements inspire us and reaffirm our belief that together, we can build a better, healthier Baltimore.

To see a short video of the ceremony, visit our YouTube page:  

Take care, Baltimore.

Friday, February 11, 2011

Food Inspections in Baltimore City

Part of being Health Commissioner not only involves tackling large policy issues such as improving the overall health and well-being of Baltimoreans, but also overseeing the activities that health department staff undertake to keep us safe and healthy every day.

I recently had the opportunity to accompany one of our 22 food sanitarians on a site inspection.  Chris Iheanacho came to work for the Baltimore City Health Department as an Environmental Sanitarian 15 years ago. Originally from Nigeria, he came to Maryland to attend college, later joining the Bureau of Food Control at BCHD. Chris has stayed in Baltimore for longer than he expected, in part because he enjoys his job so much. It was evident during the afternoon we spent together that he takes pride in the work he does.  It was also evident by the way in which he interacted with the store’s owner and manager that he is well respected as someone who is fair and knowledgeable.  

His inspection was far more involved than checking expiration dates on canned foods (though he did do this). Chris thoroughly looked for evidence of rodents; checked the temperatures of prepared deli foods to ensure that they were within a safe range; examined waste and food prep areas; and observed and interviewed staff about the store’s policies and procedures. Each of these steps is designed to make sure none of the food served in this grocery store would make a customer sick.  Along the way, he took time to educate employees on proper food handling.  He also taught me about the details of food storage requirements!  At the end of the inspection, Chris wrote a report outlining how the store fared against our safety standards.

Chris’s job is an important one. As an Environmental Sanitarian, he conducts inspections of all Baltimore establishments that serve food—restaurants, grocers, even stores that only sell bags of potato chips. Each of these businesses is subject to a rigorous evaluation to ensure that they meet the Department’s food safety standards, which are designed to protect public health and ensure that all food sold in Baltimore is safe.

Attending this food inspection was an eye-opening experience for me. It was a chance to observe the great work our employees do to protect the health of Baltimoreans; it was also an opportunity to consider how we can improve our efforts. One way to do this is by increasing efficiency. For instance, if Chris and other food inspectors had hand-held computer devices, it would be possible for him to write the final report on site, saving approximately 30 minutes per inspection. Inspectors could dedicate this time to more problematic establishments, which take longer to inspect. We are researching devices now.

Making food inspection data widely available to the public is part of my goal to make the Health Department’s work more transparent. We are currently developing a database that will allow us for the first time to share inspection data with the public. Access to this information will empower consumers to make more informed decisions about where to purchase their food. This project is in line with Mayor Stephanie Rawlings-Blake’s recent executive order to make city government more transparent and efficient.  You can check out for more info.

I want to hear from you. How do you think we are doing on food safety in Baltimore?

Monday, February 7, 2011

Maryland Commemorates the 11th Annual National Black HIV/AIDS Awareness Day

Throughout my medical and public health career, I have been involved in the care and education of individuals with HIV/AIDS. As Baltimore’s health commissioner, I am ultimately responsible for the ongoing public health emergency that HIV/AIDS presents.

You are likely familiar with the statistics:

    • In 2008, 243 Baltimore residents died of AIDS.
    • The Baltimore-Towson Metropolitan area has the fifth highest AIDS case report rate in the nation, with 29.6 cases per 100,000 residents.
    • There were 932 new HIV diagnoses in Baltimore City in 2008.
    • The disease continues to disproportionately affect African Americans, who made up 86 percent of new diagnoses in Baltimore City in 2008
    • In fact, 1 in 9 African American men between the ages of 40 and 49 years of age residing in Baltimore City has an HIV diagnosis. And that’s just men with a known positive status.
These statistics illustrate why today’s commemoration of the 11th Annual National Black HIV/AIDS Awareness Day is so important. The Baltimore City Health Department is joining the Maryland Department of Health and Mental Hygiene, national African-American organizations, the Centers for Disease Control and Prevention (CDC), and other state and local public health agencies’ efforts to address the disproportionate impact of HIV/AIDS epidemic in African-American communities.

The HIV/AIDS epidemic has had a devastating impact on the African-American community. In Maryland, as of the end of 2009, 1-in-54 African-American men and 1-in-97 African-American females were living with HIV/AIDS.  The CDC estimates that nationally, 1-in-16 African-American men and 1-in-30 African-American women will be diagnosed with HIV during their lifetime.

Knowing how long we have been battling this epidemic, those numbers are quite disheartening. That is why it is so important that we continue our work to combat the spread of this disease.

This is truly an exciting time to be working on HIV issues.  The emergence of a National HIV/AIDS Strategy has ushered in a new era of prevention and care planning.  Here in Baltimore, we are developing a citywide prevention plan in collaboration with the Mayor’s Commission on HIV/AIDS. We are also partnering on statewide efforts to combat the disease.  Baltimore has a tremendously positive and forward-thinking community of people working hard every day to get more people tested for HIV, to eliminate discrimination and stigma, and to improve linkages to quality care and services.

We must never give up on our efforts to reduce HIV and AIDS in the city. We each have a responsibility in reducing the spread of AIDS – and there is something each of us can do. Know your status. Get tested on a regular basis. This is fundamental to preventing the spread of HIV to others and to beginning treatment early.

For information about HIV education, testing, treatment and support services, please call 410-767-5132, or visit For information about Black AIDS Day events near you, please visit  To find out more about HIV in Baltimore, or to get tested, visit the Health Department’s HIV/AIDS resources Webpage.

Know Your status, B’More!

Thursday, February 3, 2011

Baltimore Kicks Off Heart Health Month

Heart health has been in the news a lot recently.  Last week, the American Heart Association released a report stating that the costs of heart disease in the United States will triple between now and 2030, to more than $800 billion a year.  On Monday, the USDA released its new dietary guidelines, which include specific measure to reduce the risk of heart disease, such as reducing daily salt intake.  And on Tuesday, a new CDC report indicated that two out of three U.S adults with high cholesterol and half of U.S. adults with high blood pressure are not being treated effectively.  

These reports indicate that, while we have made great progress in combating heart disease, there is still a long way to go.  To that end, I had the pleasure of standing alongside Mayor Stephanie Rawlings-Blake and others yesterday to kick off American Heart Month. 

Women are an especially vulnerable population when it comes to heart health. While many think of heart disease as “a man’s disease,” heart disease is the No. 1 killer of women in Baltimore City.  In fact, more women die of cardiovascular disease than the next five leading causes of death combined, including all forms of cancer.  According to the American Heart Association, cardiovascular disease kills approximately 450,000 women each year, about one every minute.

Photo courtesy of Mark Dennis
These are striking statistics, made more striking because heart disease is largely preventable.

That’s why we’re encouraging everyone to Go Red in observance of Heart Awareness Month and join the Mayor and me in wearing red in February but especially on:
  • Friday, February, 4, when we celebrate National Wear Red Day to increase awareness about heart disease among women; and
  • Sunday, February 13, in observance of Red Dress Sunday – an annual citywide initiative to educate minority women about this No. 1 killer.

These events complement the many efforts already underway to build a stronger, healthier Baltimore: 

  • On Monday, we announced the expansion of our innovative Virtual Supermarket program, which is improving food access in neighborhoods that are food deserts. 
  • With the help of the state, federal health care reform will provide the opportunity for many uninsured residents to get health coverage to provide prevention, wellness services, including health screenings.
  • The Health Department’s CHAMP program collaborates with churches to educate 400 women a year about cardiovascular risk factors. 
  • Our Barbershop initiative has screened or educated 2,500 men about heart disease.
  • And the second phase of our B’more for Healthy Babies program encourages weight reduction for expecting mothers, because “healthy moms have healthy babies.”

But heart health starts at home, and we must also do our part by taking better care of ourselves.  Mayor Rawlings-Blake encouraged Baltimoreans to take simple steps to make their hearts stronger: get educated about the risk factors for heart disease, cut salt intake, make healthy food choices, exercise regularly, quit smoking, and schedule regular blood pressure and cholesterol screenings.

I want to thank Sharesse Deleavar and her colleagues at St. Agnes Hospital; Crystal Herring and the folks at the American Heart Association’s Mid-Atlantic Chapter; CareFirst BlueCross BlueShield, The Heart Truth, and United Healthcare for their support of this important work.  Through successful campaigns like Go Red and Red Dress Sunday, we are raising awareness about heart disease among women and their families.

What about you - What steps have you taken to reduce your risk of heart disease?

Take Care of your heart, B’More!

Tuesday, February 1, 2011

Health Department Expands Virtual Supermarket Program

Yesterday I had the pleasure of joining Mayor Stephanie Rawlings-Blake in announcing the expansion of the Health Department’s innovative Virtual Supermarket Program to two new locations: George Washington Elementary School, and the Cherry Hill branch of the Enoch Pratt Free Library.

Virtual Supermarket has been a major success story for the department. In fact, it’s become a model for cities across the country working to improve food access for residents who live in “food deserts” – neighborhoods without a nearby grocery store.

Photo Courtesy: Mark Dennis
Food deserts are an underlying cause of Baltimore’s obesity epidemic. Lack of access to healthy fruits and vegetables increases the risk a person will develop cardiovascular disease, Baltimore’s No. 1 killer.

The link between unhealthy eating and poor health outcomes is especially pronounced in the neighborhoods this program serves: East Baltimore, Washington Village, and Cherry Hill.

I am especially excited to partner with George Washington Elementary.  Schools are not only important because they provide an opportunity to serve children nutritious meals, but because they are critical partners in modeling healthy behaviors.  Ms. Amanda Rice, the school’s forward thinking principal, gets that.  In addition to all of the educational opportunities she makes available for her students, she has also established a pantry in her school to make it easier for families to access fresh fruits and vegetables.

In the communities the Virtual Supermarket serves, residents must choose between shopping at small corner stores that lack fresh produce, or paying a premium for a ride far outside their area.

This is not a fair choice.

The Virtual Supermarket Project enables these residents to order groceries over the Internet at their neighborhood library or school and collect their orders on-site the next day for no delivery fee. Please check out our Webpage for more information on our locations, the ordering and deliver schedules and payment options.

Growing this program would not have been possible without the generous financial support of the Walmart Foundation and United Way of Central Maryland. We are grateful to Keith Morris of Walmart and Mark Furst of United Way for their personal and professional commitment to helping us make Baltimore a healthier place to live, work and play.

Finally, I should note that expanding the supermarket home delivery program was one of 10 recommendations put forth by the Food Policy Task Force. While it’s personally satisfying to pause and take stock of the progress we’re making, much work remains. Stay tuned for future updates on the progress we’re making to reduce food insecurity and to increase access to and consumption of healthy foods citywide.

Take Care B’More!

Welcome to Take Care, B'more!

Welcome to Take Care, B’more! I’m Dr. Oxiris Barbot, Commissioner of Health for the Baltimore City Health Department. I have been on the job for about six months, and glad to say that I hit the ground running and haven’t stopped since.  During this time I have had the opportunity to meet many of our community partners and learn from them about the challenges and opportunities facing Baltimore City.  I am heartened by the energy of the city and look forward to strengthening existing partnerships and creating new ones as the health department moves forward in our work – helping Baltimoreans live healthier lives! 

I look forward to using this space to update you on the Department’s priorities and our efforts to make healthy options the default option across the city. I will also be highlighting the work our employees do every day to promote the health of Baltimore residents. 

One of my goals is to bring greater transparency to government, and I hope this blog provides a clearer view of what the Health Department is working on and where we are heading. I’d like this to be a two-way dialogue, and I look forward to reading your comments. What topics would you most like to discuss? Together, we can make Baltimore a healthier place to live, work, and play.

If you are interested in learning more about the Baltimore City Health Department, please visit our Website, follow us on Twitter and Facebook. I also encourage you also to sign up to receive important e-mail or text message health alerts from the department.