U.S. Health and Human Services' Dr. Rachel Levine Never Sleeps

When I asked Dr. Rachel Levine, assistant secretary at the U.S. Department of Health and Human Services, how she was adjusting to D.C. life after a career spent in Pennsylvania, where she was most recently the state's health secretary, she thought for a moment. She was adjusting well, she told me, but she hasn't had a lot of time for anything else except work.

After we finished our nearly 40-minute conversation, the secretary, who made history when she was confirmed by the Senate, convinced me that indeed, her work was not only taking precedence in her life but is making waves within HHS. Dr. Levine is having an enormous influence on the administration's battle with the ongoing pandemic, working to address health disparities, mental health and addiction, healthy equity, and the impacts of climate change on health. By the end of our discussion, I was exhausted!

She began by reaffirming that the department, along with the administration, is doing everything conceivably possible to address the pandemic crisis, an effort she had led back in Pennsylvania. "As a member of the Task Force, we are working to continue expanding the availability of safe and effective vaccines," she said. "And once we get enough people in this country vaccinated, we'll extend our current efforts globally."

I asked Levine if the new mandates and recommendations, from the administration, state and local governments, the Centers for Disease Control and Prevention, and private businesses have had an effect on the number of people who have been vaccinated. "Yes, we're starting to see more people immunized. On top of that, Pfizer announced their research data is available for those under 11 years old, so they're awaiting action from the [Food and Drug Administration] and CDC. It's very important that these safe and effective vaccines are utilized by children, so we're working with pediatricians about how we will roll out that immunization program."

Levine said that the task force is working collaboratively and continuously with state and local governments, on all fronts, including instituting the new booster program that was just approved by the FDA and CDC. "We are literally working night and day."

Part of that, she explained, is the recent completion of a health equity study, which is a critical component of the ongoing battle. "We have a Health Equity Task Force that I co-chair that just approved recommendations on ensuring prohibition of discrimination based on sexual orientation, gender identity, and providing care to underserved, minority and disadvantaged communities," she said.

The general tenor of the findings is that the pandemic, like nothing else in history, has shown the disparity of health care in the United State, she noted. "The lack of quality health care impacts some communities of people of color, African-Americans, Alaskans, Indian reservations, LGBTQ people, and others," she said. "We worked on a series of recommendations to address the inequities and improve the availability and access to the vaccination program. The comprehensive report was sent to the White House, and we should be able to announce the findings by the end of October."

Another important part of Levine's work is the mental health issues that go along with addiction. "These are afflictions that impact all age groups," Levine said. "Last year, through the dark days of the [ongoing] crisis, we had over 94,000 overdoes over 12 months. Addiction and mental health were two of my top priorities when I served as Pennsylvania's secretary of health.

To that end, Levine said that HHS Secretary Xavier Becerra earlier this summer started the Behavioral Health Coordinating Council. "I'm honored to also cochair that council along with Assistant Secretary Tom Coderre," she commented. "We are studying all aspects of addiction and overdose, along with representatives from just about every health department in the U.S. government, including [National Institutes of Health], FDA, and others. We want to expand access to lifesaving treatments to physicians. We're looking at prevention measures, community-based programs, targeting schools, as well as looking for treatments that work effectively towards recovery."

And Levine isn't finished yet. She told me that she's very excited about the establishment last month of the HHS Climate Change and Health Equity Office, of which she is also cochair. "Unfortunately, some of the same groups disproportionately impacted by [the pandemic] will be the same groups struggling the most with the effects of climate change on our health," she remarked. "We will use the lessons learned ... to address these disparities, prioritizing and protecting the nation's health."

I told Levine about my work with climate change for the United Nations and the fact that this office is crucial, as climate change is not an issue of the future but something that needs to be dealt with now. "Yes, that's right," she said. "We are seeing the impacts now, particularly as it relates to health. All of the health-related issues from hurricanes, storms, flooding, forest fires, and heat problems, to name a few.

"For example, the health of farmers is under duress because of extreme heat, and seniors without air conditioning in areas like Portland and Seattle that have experienced record heat. Finally, we're partnering with health systems on resilience and even on emissions. It's a little-known fact that the U.S. health care sector is responsible for 8.5% of the U.S. carbon emissions, so we want to change that."

Since Levine doesn't get much time off with all of these responsibilities, I asked her if she's at least enjoying the work. "I'm very much enjoying the job. We have a fantastic staff, and Secretary Becerra is wonderful, sincere, and compassionate. I love collaboration, and that collaboration for the issues we're working on extends all the way up to the president and vice president, and that's something that Americans of every stripe should take great comfort with."

John Casey is editor at large for The Advocate.