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- Professor of Pediatrics and Psychiatry
As head of the U.S. Public Health Service Commissioned Corps, Dr. Rachel Levine leads a group of 6,000 uniformed public health officers whose duties range far beyond the COVID-19 pandemic.
Levine, a pediatrician, became the highest-ranking openly transgender official in March when the Senate confirmed her as assistant secretary of health. On Tuesday, Levine will be sworn as the nation's first openly transgender four-star officer across any of the eight uniformed services.
Levine served as Pennsylvania's top health official and spearheaded the state's response to the COVID-19 pandemic and the opioid epidemic epidemic. She also focused on other pressing health issues, such as maternal mortality and childhood immunization.
Her new role puts her at the forefront of deploying a public health workforce in demand more than ever amid a pandemic that has killed more than 725,000 Americans, a fentanyl-fueled overdose epidemic, border health challenges, and emergencies such as flooding. She also has received queries from a group of senators about the importance of treatment and mental health guidance for transgender and nonbinary adolescents.
In an interview with USA TODAY, Levine acknowledged the "significant and profound responsibility" of her appointment and the job ahead.
USA TODAY: Can you explain what you mean by the significant and profound responsibility of this new position?
Rachel Levine: When I say it's a responsibility, we have 6,000 commissioned corps officers in the United States public health services who do just such fantastic work throughout public health and health and human services. But they are also deployed in some other departments. We had fantastic officers at the Pennsylvania health department. So it’s a responsibility to lead the core.
What lessons can we learn from the pandemic?
Levine: We are all interconnected. What any one of us does has significant impacts upon our family, our community and our nation. So I think there is a personal responsibility people have to the common good.
The second is the profound importance of public health. It has highlighted the service and the commitment of our United States Public Health Service Commissioned Corps officers. They have had more deployments through this time than ever before. They are serving at the CDC, the FDA, the Indian Health Service, the Bureau of Prisons. But so many have had deployments for the COVID response as well as to the border and for catastrophic flooding from Louisiana to Tennessee to throughout the country. The pandemic has highlighted their service, and just in general, the importance of public health and the necessity for ongoing funding for public health at the local, state and federal level, as well as for the workforce and the data and IT capability.
Drug overdoses are at record levels. What needs to be done to slow these deaths?
Levine: It is the crisis within the pandemic. The latest data show approximately 95,000 or more deaths due to overdoses in the last 12-month period, which is the most ever seen. We have a coordinated response across HHS (the Department of Health and Human Services). I co-chair the behavioral health coordinating council with Dr. (Miriam) Delphin-Rittmon, the assistant secretary for SAMHSA (Substance Abuse and Mental Health Services). We are looking at all aspects of mental health, including overdoses and the opioid crisis.
One thing we have seen is it’s not just opioids. It also includes, for example, stimulants such as methamphetamine and cocaine. But the highest rate has been due to fentanyl-related substances, which have been found in other drugs such as methamphetamine and cocaine. The DEA (Drug Enforcement Administration) put out a recent advisory about fentanyl-related substances pressed into small pills that might look like OxyContin or even something like Xanax or Adderall.
So our response has four pillars. The first is prevention. The second is harm reduction, speaking of that broadly, such as naloxone, fentanyl strips and syringe service programs. The third is treatment, particularly for opioid use disorder, an emphasis on medication-assisted treatment such as buprenorphine medications. And the fourth pillar is recovery. We have plans to increase all of those through HHS.
U.S. Sen. Chris Murphy recently sent a letter to you about the mental health needs of transgender and nonbinary youth. Under your leadership, what can we expect to done?
Levine: We will be pulling together a group. In fact, we already have a group in terms of our LGBT coordinating council. We are going to be discussing this with our partners such as SAMHSA, CDC and HRSA (the Health Resources and Services Administration) to discuss what specific recommendations and guidelines we can make for vulnerable LGBQT+ and particularly transgender youth. This is the face of, unfortunately, very challenging legislation in other states, that seek to remit care, standard of care, for those youths. So we will be developing recommendations.
Ken Alltucker is on Twitter as @kalltucker or can be emailed at firstname.lastname@example.org.
This article originally appeared on USA TODAY: Rachel Levine sworn in as first openly transgender 4-star officer