During the height of the pandemic, the Cuyahoga County Board of Health (CCBH) played a pivotal role in community information, education, and vaccine distribution. At the time, it was led by Terry Allan, who recently retired as the Health Commissioner for the Cuyahoga County Board of Health. Allan’s successor is Dr. Roderick Harris, who previously worked at the Allegheny County Health Department (Pittsburgh, PA), until he was hired to come back home to Cleveland in April 2022. As he approaches the end of his first year in the new position, the Center for Community Solutions sat down with Dr. Harris to get to know him, the Cuyahoga County Board of Health, and what to expect in the future of public health in the current national environment.
About The Cuyahoga County Board of Health
CCS: Tell me about your position at the Cuyahoga County Board of Health. What are you responsible for individually? How many staff do you work with? And how does your position interface with the CCBH?
Harris: I’m hired by the Cuyahoga County Board of Health (CCBH), which appoints the Health Commissioner. CCBH is an independent authority, therefore, I’m not hired by the County Executive. CCBH has a five-member Board, and they do not have term limits, which allows us to have substantial institutional knowledge among members. They each serve five-year terms, so every year a Board member is up for election or re-election. CCBH Board members are appointed by a District Advisory Council, comprised of mayors from the villages and townships around the county. In a nutshell, the Board members are my bosses. The Board handles the oversight of the agency, but the Health Commissioner (who is like the CEO) handles the day-to-day operations. We have approximately 190 employees spread over five service areas.
We work closely with the Ohio Department of Health (ODH) and many of our agency’s responsibilities are spelled out in the Ohio Revised Code and the Ohio Administrative Code. ODH also helps to fund many programs within CCBH.
CCS: What exactly is the CCBH responsible for and how is it impacted by other levels of government at the federal, state, and local levels?
Harris: We have five service areas:
- Environmental Public Health. This is really the enforcement section of CCBH and what most health departments are generally known for. Programs include Food and Restaurant Inspections, Pools & Beaches, Body Art, Household Sewage, Mosquito Control, Rodent Control, Climate Change, and Lead Poisoning Prevention. Also included in the Environmental division is the Overdose Data to Action program, which strives to prevent drug overdoses in the county through outreach, naloxone distribution, and linking people to treatment.
- Epidemiology. This unit monitors the health outcomes of our community, including outbreak trends. Our emergency and disaster preparedness staff are also a part of this team.
- Population Health. This is where many of our community-based programs are housed, such as the Racial & Ethnic Approaches to Community Health project, Youth Health, Maternal & Child Health, and the Ryan White HIV/AIDS program.
- Nursing & Clinical Services. Staff includes our on-site clinical team, Disease Intervention Specialists, Newborn Home Visiting Nurses, School Health Nurses, and a small dental team.
- Administration. This section encompasses Finance, Communications, Human Resources, Legal, Performance Management, and Equity, Diversity & Inclusion.
I wanted to become a health inspector to hold these companies accountable and do my part to prevent this from happening to disenfranchised communities.
About Dr. Harris
CCS: What inspired you to enter the field of public health?
Harris: I wanted to be a physician, but when that plan didn’t work out, I explored other ways to make people and communities healthier. I changed my major to environmental health and the rest is history. I learned about environmental justice and about housing projects being built on landfills in the 60s and 70s which led to birth defects and cancer. So, I said to myself, “This is unacceptable.” I wanted to become a health inspector to hold these companies accountable and do my part to prevent this from happening to disenfranchised communities.
CCS: Tell me about your journey in public health as well as your experience in Allegheny County, and how those experiences have shaped your understanding of public health.
Harris: The early years include time as an inspector here at the Cuyahoga County Board of Health! I was assigned to cities on the eastern side of the county. A couple of things that I noticed is that I was only one of two Black inspectors within the organization, and there were differences in what I observed during inspections within predominantly minority neighborhoods versus what previous inspectors observed. Mine were more thorough. That concerned me because these were communities already facing challenges and operators were not being held accountable for food safety. That motivated me to pursue leadership positions to make sure that communities were getting the quality services they deserved. In order to be a health commissioner, you need a Master’s in Public Health or a similar degree. I decided to go to school for public health at Meharry Medical College, a historically Black medical school with a legacy of training professionals to transform the health of underserved communities. Later, I pursued my Doctorate at the University of Pittsburgh. I then got a job as the first Center for Health Equity Director at the county health department in Wichita, Kansas where I worked for six years, before arriving in Pittsburgh to serve as a Deputy Director of the county health department. I grew my oversight over the eight years I was there, eventually overseeing 130 employees who were dispersed across 12 locations. And now, I have come back home to Cuyahoga County.
General on Public Health
CCS: How does it feel to be in a public health leadership role and public health administrative space when there is so much discussion about public health and safety and uncertainty on when things will go back to “normal?”
Harris: I always say that public health is a thankless job because it’s hard to measure things that you prevent. It is a constant struggle to quantify our value. But I remember my “why” every day when I do this work. The pandemic highlighted the value and importance of public health systems. When investments are made toward planning, preparation, and resources, public health systems can better create more resilient communities.
When you want to take organizations and communities to the next level, people who are in their comfort zones tend to resist.
I always tell my staff to remember that leadership Is not a popularity contest. When you want to take organizations and communities to the next level, people who are in their comfort zones tend to resist. You can’t be in this work if you want to make friends and if you want everyone to like every decision that you make. We need to be firm in our decisions, while also being agile on the path forward, in case the data show that we need to pivot. Don’t get into this line of work if you can’t take criticism.
CCS: As you have been in the job for about a year, what has been your observation, and what has been your biggest surprise?
Harris: Of the good things I’ve observed, it’s pleasing to see philanthropies involved in public health issues and health equity, such as violence prevention and infant mortality. When we look at the leading causes of death among Black males, across the United States, the top cause of death for men under age 40 is homicide. Fortunately, the CCBH Board recently created a Violence Prevention Subcommittee to explore what our role can be in this space.
My biggest surprise was I didn’t see a lot of collaboration between the city health department and the county health department. It was surprising and concerning to me that we weren’t working together. We owe the city and county residents more than that. Now, Dr. Dave Margolius [public health director for the City of Cleveland] and I meet monthly to talk about opportunities for collaboration. We need to get away from the mentality that what happens in the city doesn’t have anything to do with the suburbs. When violence happens, when public health crises happen in the City of Cleveland, suburbs need to care. There are no boundaries for viruses and illnesses. People live and work in the city, so you should want to have a healthy city, even if you live outside of it. When COVID first happened, we heard a lot of stories about people saying “COVID isn’t in my neighborhood”…that sense of privilege changed quickly. The 1.2 million residents of Cuyahoga County should be unified as we pursue optimal health for all.
CCS: What can advocates and health and human service organizations do to support the work of CCBH?
Harris: I want people and partners to understand that the health department can’t be all things to all people. The public health system needs to work together—health clinics, hospitals, paramedics, medical providers, preventive care, but also non-traditional partners such as churches, schools, and media—because we all have a role to play.
People who want to advocate and support public health should think about what they can do within their control. I would also encourage people who care about public health to “make the healthy options, the default options.” For example, small changes can be made with lunches you make for your kids, the food you allow at your gatherings or even your company’s guidelines for purchases.
CCS: Can you share some general advice for those who wish to impact social determinants of health? There has been a great deal of focus on racial disparities both locally and nationally, both in terms of life expectancy and quality of life, as well as declarations of racism as a public health crisis both at the city and county levels.
Harris: Everyone who cares about public health should understand their spheres of influence. Those who work in public health know that policy changes things. Do what you can to speak truth to power. Local governments, parent groups, grassroots organizations, etc., can help counter the social determinants of health that lead to poor health outcomes. They should be speaking about the potential health impacts of regulations, proposed plans, and new developments.
CCS: Can you talk about how your experiences as a Black man in the field of public health provide a unique vantage point that you are able to use to inform your work at CCBH?
Harris: Being a Black man in this position and growing up on Kinsman Road motivates me and shapes my experience when working to address health disparities related to food insecurity, crime, and unsafe housing, among other health topics. I want to ensure that people get the quality services that they deserve. I want citizens to know that CCBH exists. We need to make sure people know what we do. They need to know that CCBH is working for them every day. I want people to think of CCBH as a part of their lives and that they are a part of ours. We’re all in this together. I know what it is like for communities to feel alone and forgotten about. I will do my best to not have that happen under my watch.
I want to ensure that people get the quality services that they deserve.
CCS: Any closing thoughts?
Harris: As I mentioned, CCBH has employees who inspect restaurants, pools, landfills, septic systems, etc. The job title is “Registered Environmental Health Specialist” (REHS). To assure that our staff composition is representative of the communities we serve, I would like to see more diversity among the REHS workforce. In general, more people to color working in the field of environmental health would be great as the public health systems combat structural racism, historical impacts of redlining, and environmental injustices. Visit www.CCBH.net for open positions.
I would also want to add that we have summer positions that we are having a difficult time filling. I would love to have students from local colleges and universities in these $15/hour roles.