Public Health | Mount Sinai Today

Rachel Levine, MD, Reflects on Her Years at Mount Sinai and Her Historic Confirmation

Updated on Jun 30, 2022 | Diversity and Inclusion, Featured, Public Health

Rachel Levine, MD, was sworn in as Assistant Secretary for Health on March 26, 2021.

Rachel Levine, MD, a longtime leader in public health, was sworn in as Assistant Secretary for Health in the Department of Health and Human Services in March 2021—making history as the first openly transgender federal official to be confirmed by the U.S. Senate. Dr. Levine, who began her medical career at Mount Sinai, recently took part in an interview with Mount Sinai Today about her years of training and the road ahead.

Dr. Levine took on her new post after nearly 40 years in adolescent health and public health, most recently serving as Pennsylvania’s Secretary of Health. At her confirmation, she said, “I am both humbled by the opportunity and ready for the job.”

As a young physician at Mount Sinai, was becoming a national leader in public health one of your goals?

I received fantastic training in pediatrics and adolescent medicine at Mount Sinai, and at the time I really saw my career in academic medicine. I did my residency program at Mount Sinai from 1983 to 1986. I was chief resident from 1986 to 1987. I did my fellowship from 1987 to 1988, and then I was part of the voluntary faculty and kept my association with Mount Sinai through 1993, when I left to go to the Penn State College of Medicine. It was 10 years of association with Mount Sinai, and I found it to be absolutely wonderful. But I actually did not see myself in the type of role that I have now.

Were there experiences at Mount Sinai that you found especially formative?

Serving as Chief Resident of Pediatrics at The Mount Sinai Hospital was really one of the formative leadership experiences of my life. I had a tremendous amount of responsibility in terms of leading 25 to 30 residents, helping them with all the patients on all the floors, dealing with emergencies, and taking on administrative responsibilities for the unit—all under the mentorship of Kurt Hirschhorn, MD, then the Chair of Pediatrics, and Alexander Hyatt, MD, the Vice Chair. In years since, I think the job has been divided among two or three people, so the Chief Resident in 1986 had a lot of responsibility. I kind of joke that only now have I finally found a job that equals being Chief Resident of Pediatrics at The Mount Sinai Hospital.

Dr. Levine was the keynote speaker at Mount Sinai’s White Coat Ceremony in 2015.

Could you talk about a few of your mentors at Mount Sinai?

Probably the biggest mentor I have had in medicine is Dr. Hirschhorn, Professor Emeritus of Pediatrics, Genetics, and Medicine, and Chairman Emeritus of Pediatrics. He is just an outstanding academic medicine physician, and he was a great chair and mentor. One of my most vivid memories of Mount Sinai was morning reports, where we would present the cases that came in the night before, and Dr. Hirschhorn was always there. We would discuss the admissions and then the diagnoses and the challenges, and it was a fantastic formative learning experience.

There are so many other mentors I could name, including Dr. Hyatt; Scott Barnett, MD; Les Jaffe, MD, who was head of the adolescent program during my entire time at Mount Sinai, and Angela Diaz, MD, PhD, MPH, Director of the Mount Sinai Adolescent Health Center. Dr. Diaz was a third-year resident when I was an intern and an attending in the adolescent clinic when I was a fellow. That may not seem like much of a difference, but she was senior to me, always a couple of years ahead. What I remember most from those days was her great compassion and dedication. Then and now, she is passionate about adolescent medicine and taking care of teens in the community.

The COVID-19 response was one of your top priorities as Pennsylvania’s Secretary of Health and in your federal position now. What are the biggest challenges in the pandemic now?

Our main focus now is the vaccination program. For months it was supply and the challenge of distribution and administration. But I think we are exactly at that tipping point where the most important challenge is vaccine hesitancy. Through the efforts of the Biden-Harris administration, we now have adequate supply of three safe and effective vaccines, but we now need to work past people’s hesitancy about the vaccines. One role that I hope to play is helping with this messaging as the vaccines receive Emergency Use Authorization for adolescents and perhaps younger children.

What are your other top priorities as Assistant Secretary for Health?

Addressing the continuing issue of the opioid crisis and overdoses is an important priority. We are also focusing on the public health impacts of environmental health and climate change. In an executive order, President Biden has created a new Office for Climate Change and Health Equity, and that is part of my office. As our climate changes and we look at the public health impacts, we want to make sure that we’re looking at vulnerable communities—African American communities, Latino communities, and American Indian and Native Alaskan communities. We know that there are significant health disparities, and we’re concerned that these communities are bearing the brunt of the impacts of climate change. We want to study these disparities and develop policies to address them.

What does the historic nature of your appointment mean to you?

I like to say that I may be the first transgender federal official to be confirmed by the Senate, but I won’t be the last. And here I’m building on a quote from Vice President Harris, who said that as a Black and South Asian woman, “I may be the first to hold this office, but I won’t be the last.” We’ve come a long way in the LGBTQ community, but we certainly have a long road ahead. We need to raise awareness, and we need to work in terms of health equity for LGBTQ individuals, particularly LGBTQ youth.

You were confirmed by a bipartisan vote of 52-48, but in your hearing you faced some opposition and adverse reactions. How do you handle this kind of situation?

I really think that any hostility comes from a place of fear—that people fear what they don’t understand, and so I want to educate people. Even my being the Assistant Secretary for Health shows people that transgender individuals and LGBTQ individuals are like everyone else. We’re physicians; we’re teachers; we’re lawyers; we are everywhere in society and in our government as well. And I want to show LGBTQ youth that with hard work and perseverance you can be anyone, and you can be anything.

Colleagues Salute Rachel Levine, MD:

“Dr. Levine’s appointment is both historic and emblematic of how far we have come in recognizing the accomplishments and the contributions of LGBTQI people to making our health care and our society more equitable, inclusive, and compassionate for all. Mount Sinai gave Dr. Levine a powerful foundation to build on, and today it is meaningful that during Pride Month 2021, we celebrate one of our alumni and acknowledge our ongoing commitment to enhancing and expanding service, education, and advocacy for the diverse LGBTQI communities we serve.” -Barbara Warren, PsyD, CPXP, Senior Director, LGBT Programs and Policies, Mount Sinai Office for Diversity and Inclusion

“I could not be more thrilled for Dr. Levine, or more proud of her. She is enormously accomplished and a fierce proponent of health equity, adolescent medicine, and transgender health—all critical issues that are close to my heart. We worked together when she did her pediatric training and Adolescent Medicine fellowship at Mount Sinai. I could see even then just how talented, dedicated, and compassionate she was. Dr. Levine’s confirmation is a truly historic moment, and I cannot think of anyone more deserving.” – Angela Diaz, MD, PhD, MPH, Director of the Mount Sinai Adolescent Health Center

“During her confirmation hearing, Dr. Levine never lost protocol. She remained very strong and confident in where she was coming from, and that resonated with what I remember about her back at the Adolescent Health Clinic. I never ever saw her get upset about anything; she was always so competent, calm, and confident, and the patients really liked her as their physician. I’ve enjoyed following her career, and she is a perfect fit for the position.” – Leslie Jaffe, MD, Director of Mount Sinai Adolescent Health Center, 1982-1989

”Dr. Levine is a great communicator with a passion for public health, and she will do a great amount of good in her areas of focus, which include opioid addiction and the COVID-19 response. That she has also been willing as a trans woman to stand up and be so visible is very important for other trans people to see for reassurance and for cisgender people to see as we break down barriers. It is an honor for us at Mount Sinai to be associated with a pioneer in an area where we now take a leadership role.” – Joshua D. Safer, MD, Executive Director of the Mount Sinai Center for Transgender Medicine and Surgery

The Mount Sinai SAVI Program Observes Sexual Assault Awareness Month

Updated on Jun 30, 2022 | BFWHRI, Blavatnik, Community, Public Health

As our communities navigate the ongoing coronavirus pandemic, we must not forget the importance of Sexual Assault Awareness Month this April. Sexual assault occurs when unwanted, unwelcome sexual behaviors are forced upon someone without their consent. According to the most recent Department of Justice National Crime Victimization Survey, every 98 seconds, a person in the U.S. is sexually assaulted.

The Mount Sinai Sexual Assault and Violence Intervention Program (SAVI) was founded in 1984 to respond to this public health crisis in Manhattan and Queens by advocating for the rights of sexual violence survivors to be believed, supported, and centralized through free trauma-informed services and advocacy. Since SAVI’s doors opened, survivors of sexual and intimate partner violence and those closest to them have accessed SAVI’s free counseling by calling SAVI’s main intake line at 212-423-2140.

Each fall, SAVI has provided a 40-hour classroom-based training to prepare volunteer advocates to provide onsite emotional support and advocacy for survivors in the Emergency Department. The SAVI Advocate training is one of the many free prevention and trauma-informed response educational opportunities that SAVI provides. SAVI also has specialized capacities to address specific community needs, such as the Takanot Program, which serves Orthodox Jewish survivors of sexual and intimate partner violence, and anti-Commercial Sexual Exploitation interventions and services.

To continue raising awareness of the prevalence and prevention of sexual violence, SAVI observes Sexual Assault Awareness Month (SAAM) this April. SAAM is centrally coordinated by the National Sexual Violence Resource Center, who produce free awareness print and media resources on their website.

Denim Day: Last Wednesday of April (4/28)

Per organizers Peace Over Violence, who started this campaign 21 years ago:

“The campaign began after a ruling by the Italian Supreme Court where a rape conviction was overturned because the justices felt that since the victim was wearing tight jeans she must have helped the person who raped her remove her jeans, thereby implying consent. The following day, the women in the Italian Parliament came to work wearing jeans in solidarity with the victim.”

More information can be found at denimdayinfo.org.

The Mount Sinai community was invited to participate in Denim Day by –

WEARING denim (with supervisor permission)
Taking a SELFIE in denim
POSTING this image on social media (Instagram, Facebook or Twitter) with the HASHTAG #denimdaysavi
TAGGING @mountsinaisavi

JOIN one of our Denim Day webinars to learn more about ways to interrupt sexual violence, and victim blaming culture! Register here.

SAVI hopes that someday, SAAM and even their program will no longer be necessary but until then, you can be part of the movement by joining their mailing list (email SAVIPresents@mssm.edu) and following @mountsinaisavi on social media to learn about campaigns, actions, and other opportunities to take a stand against sexual violence.

Amanda Burden (she/her/hers) brings more than 15 years’ experience as an educator, program manager, and public health professional to SAVI as the Training and Education Outreach Supervisor. Since joining the program in 2016, Burden has facilitated the delivery of trauma-informed education, public health campaigns, and subject matter expertise to thousands of volunteers, trainees, staff, clinicians, and faculty across the Mount Sinai Health System. To inquire about the program’s free sexual or intimate partner violence prevention or response resources and education available for your communities, please visit the SAVI website or call the main line at 212-423-2140.

If you or someone you know is experiencing, or healing from, sexual or intimate partner violence, please let them know that they are not alone, and to call 212-423-2140 when they are ready to speak to a free counselor at SAVI.

Public Health Students Continue Training during COVID-19 Pandemic

Updated on Jun 30, 2022 | COVID-19, Featured, Public Health

Throughout the COVID-19 pandemic, Master of Public Health (MPH) students from the Graduate School of Biomedical Sciences at the Icahn School of Medicine at Mount Sinai have stepped up to the challenge of balancing their training in public health, continuing their in-progress research and outreach work, and taking on new responsibilities in managing the spread of the virus. Students have been involved in COVID-19 clinical care, research and the development of therapies, as well as volunteer work. This includes placing update calls to patients’ families, directing calls to resource hotlines, and coordinating food drop-offs to New York City residents. Showing resilience in the face of an unprecedented situation, students continued to meet the milestones of their professional degree program, and in May, the students celebrated yet another major accomplishment—the presentation of their MPH Culminating Experience project at Public Health Research Day.

More than 50 MPH students presented their graduate-level research at the first-ever virtual meeting of Public Health Research Day on Thursday, May 28. To bring the Mount Sinai community together, the Graduate Program in Public Health kicked off this year’s event with a timely lecture by Jessica Metcalf, PhD, Assistant Professor of Ecology, Evolution and Public Affairs at Princeton University, on the use of serology in monitoring health during the pandemic. Afterward, four students were given the honor of presenting their research in long-form oral presentations to more than 100 attendees on Zoom.

Sofia Bengoa presented work on the East Harlem built environment and its effects on adolescent well-being. Charles Sanky described results of the social determinants of health and patients’ lifetime experiences of discrimination as surveyed within an emergency department. Rui Jiang shared work on leveraging hyperlocal epidemiology to capture missed breast cancer screening opportunities. The last honored speaker was Shivani Rathi, who discussed the effects of early childhood stress, adult resilience, and sexual orientation in Gujarat, India. The afternoon followed with each student’s virtual poster presentation in specialty areas like health care management, epidemiology, global health, health promotion, and other public health fields. The following MPH candidates were recognized for their outstanding poster presentations: Debjyoti Datta, Salvatore Crusco, Erona Ibroci, Kayla Jaeckel, Charles Sanky.

The Graduate Program in Public Health united the student community for a uniquely heartfelt virtual gathering in which three MPH alumni candidly shared their post-graduation experiences. Molly Libou, MPH, Research and Surveillance Manager in the Bureau of Alcohol and Drug Use Prevention, Care and Treatment, NYC Department of Health & Mental Hygiene, walked students through her job search strategies and encouraged students to jump at opportunities to learn and advance in the field. Michael Smith, MPH, HIV Consultant, United Nations World Food Programme, earnestly shared how grueling work projects, like writing and rewriting a master’s thesis, were learning experiences that better prepared him for more significant challenges in his career. Finally, Erica Palladino, MPH, Public Engagement and Strategic Communications Fellow in the Office of the Surgeon General, illustrated the importance of preparing for your future workplace, but also acknowledged that learning will happen on the job as well.

“These are historic times for Public Health,” said Nils Hennig, MD, PhD, MPH, Director of the Graduate Program in Public Health. “We are all reminded how important the role of public health education, practice, and leadership is during this time. I have never been more proud of our students, faculty, and staff than in their response to the COVID-19 pandemic. In our program, I see an unwavering dedication to the public’s health.”

Staying Safe During the COVID-19 Pandemic and Beyond: A Guide for IPV Survivor Well-Being

Updated on Jun 30, 2022 | COVID-19, Featured, Public Health, Your Health

Isolation, uncertainty about tomorrow, and fear of consequences that are out of their control can be common experiences, especially for those in abusive relationships. According to Angela Fernandez, Assistant Director of the Sexual Assault and Violence Intervention (SAVI) Program at Mount Sinai, the voluntary seclusion that many have been practicing in order to prevent the spread of COVID-19 may be compounding these realities for survivors of intimate partner violence.

“Abusers will often isolate a survivor and disconnect them from their support network,” says Ms. Fernandez. “COVID-19 is just another factor that makes these challenges harder for a survivor.”

How can survivors remain safe and connected to support when physical distance is essential for safety? As we weather the current pandemic, Ms. Fernandez provides safety tips for survivors—and their loved ones—that are applicable now and as we enter a new normal due to COVID-19.

Identify a “go to” person or network of people in your physical or digital community.

As much as possible, create scheduled check-ins with your support network, and identify at least two people you can contact with an established code word or phrase that will let them know that you are in trouble. Using this word or phrase will indicate that you need an immediate help or intervention.

Discuss with your support network what “getting help” means to you.

“Getting help” is a catch-all phrase that could mean any number of things. Be sure to let your support network know what should happen immediately after you use a code word/phrase/sentence. Would you like someone to help de-escalate a situation, should someone call 911, or do you need to leave?

“Every survivor’s situation is unique and evolving,” says Ms. Fernandez. She notes that physical violence is often seen as the main threat to a survivor’s safety, despite the prevalence of psychological, emotional, and sexual abuse—which are often concurring and are equally damaging to their well-being. “Using a code word or phrase could very well indicate the immediate need for emotional first-aid as much as a physical intervention.”

Be prepared to leave if your situation escalates.

Think about the easiest and safest routes for you to get out of your home quickly, if necessary. Keep an emergency bag that you can quickly fill (or, pre-packed if safe to do so) with a portion of your medication, money, important documents, and food and that you can access on your own time. Keep your identification on you as much as possible.

Identify the “safest” spaces inside.

To protect yourself during times of escalation, think ahead about what spaces feel safest. This might mean a room where there are no weapons (i.e. avoiding the kitchen) and/or has easy access to a door or window to exit the house or apartment. Identifying the safest areas within the home can at least reduce the risk of harm.

If you are part of a survivor’s support network, remember that the person experiencing intimate partner violence knows their situation best.

What you believe to be best may differ from the survivor’s lived experience. In fact, for a survivor, the risks of leaving can often outweigh the risks of staying—especially during a pandemic that has exacerbated economic instability.

Supporters should be careful not to take control away from survivors, which is what the abuser is doing on a daily basis.

“When we look at the power and control dynamics, just because you think you are taking action with good intentions, doesn’t make it any less disempowering for a survivor,” says Ms. Fernandez. “We should be helping to re-empower that person by making sure they have space to consider what is best for them.”

This is especially important now when there are fewer resources available due to the pandemic but holds true during “normal times,” Ms. Fernandez says. Seeking police intervention should be the exception and not the general practice for supporting survivors of intimate partner violence, she says, but this calculation changes if there is a threat of serious and imminent harm.

If you or a loved one needs advice, assistance, or support regarding sexual assault or intimate partner violence; the Sexual Assault and Violence Intervention (SAVI) Program at Mount Sinai is available to help. For more information, visit the SAVI website or call 212-423-2140.

Additional resources include the National Domestic Violence Hotline and Safe Horizon, which provides social services for survivors throughout the five boroughs.

Learn more about SAVI

Vigils for Justice, Equality, and Health Equity

Updated on Jun 30, 2022 | Diversity and Inclusion, Featured, Public Health

Clinicians across New York City joined in a “White Coats for Black Lives” march on Saturday, June 6, from Central Park’s East Meadow down Fifth Avenue to Columbus Circle. Hundreds of health care workers and medical students—wearing the requisite face masks—were demonstrating to address a range of issues, including the murder of George Floyd in Minneapolis and structural racism that has contributed to disparities in health, both during the COVID-19 pandemic and long before.

The event was led by White Coats for Black Lives, a medical student-run organization that was born out of demonstrations in 2014 after Michael Brown in Ferguson, Missouri, and Eric Garner in Staten Island were killed by police. Since then, the group has formed chapters around the nation with this mission statement: Eliminating racism in the practice of medicine and recognizing racism as a threat to the health and well-being of people of color.

Sites across Mount Sinai have also held vigils—including powerful events on Tuesday, June 2—in which participants observe 8 minutes and 46 seconds of silence, the amount of time George Floyd was held under a police officer’s knee, suffocating to death. Demonstrations also focused on Breonna Taylor, an African-American emergency room technician who in March was killed by the police in her own home in Louisville, Kentucky.

At noon on Thursday, June 11, 1199-SEIU encouraged its members to take that pause to show solidarity for George Floyd and so many others who came before him. Many 1199 members gathered outside of Mount Sinai Beth Israel to participate. And at Mount Sinai West and Mount Sinai Morningside, vigils were led by unions including 1199 and the New York State Nurses Association. Members of hospital leadership at the sites joined in solidarity.

View References and Resources from the Office for Diversity and Inclusion

Mount Sinai is United in Solidarity

The Impact of COVID-19 Within Black and Hispanic Communities

May 28, 2020 | COVID-19, Diversity and Inclusion, Public Health

The COVID-19 pandemic has hit African American, Hispanic, and poor communities across the United States particularly hard. The health disparities that existed before COVID-19 have been greatly exacerbated, with a disproportionate impact on these communities. The questions are why, and what to do about it.

In this Q&A, we spoke with Icahn School of Medicine at Mount Sinai professor and public health research scientist Luz Claudio, PhD.

Why are we seeing such high rates of COVID-19 among African American and Hispanic people?

Health disparity by race, ethnicity, and income is a thing that we know about. There is even a National Institutes of Health institute dedicated to that issue. COVID has just blown the lid off this boiling problem that was already there. It’s been far too long that minority communities, minority people of color, low-income people have been suffering from higher disease levels and more severe disease in many cases.

How are communities of color particularly vulnerable to COVID-19?

There are several factors that contribute to higher rates of disease and death from COVID-19 among people of color. One is that many work in the newly “essential” jobs—where they are exposed to the virus—and are going back home to their families—further spreading the condition.

Another issue is crowding in the household, as people of color tend to have higher numbers of people living in one household—sometimes several generations in one home. Young people, who are risking themselves out there working, often have no way to self-isolate in their household and may inadvertently expose people who are more vulnerable than they are in terms of age or having other diseases.

Not only do they have these conditions more often, but also they’re out there. They’re working in these jobs and they’re being exposed to everything.

Importantly, as our research and that of many others has found, communities of color have higher rates of the very chronic diseases that increase the risk of death due to coronavirus.

How can health care organizations help to make up for disparities?

One of the things that we can do now, instead of waiting until the pandemic is over, is research, as Mount Sinai and other institutions are doing. We need to make institutional policies that correct the health disparities now, not just track them. We need to act now.

Prioritize the people at risk. If you’re only 46 years old but you have diabetes, that should be part of the priority station for testing you for COVID. We should prioritize people at risk because of their comorbidities, and that is going to be mostly minority people. Another thing that we can do is outreach where there is greater risk. Partner with trusted community-based organizations to get the testing and messaging out.

How can health care organizations alleviate any mistrust between themselves and vulnerable populations?

As an institution, we can partner with community-based organizations that already have that kind of trust as a bridge and really collaborate with them equally.

This is a good example of the way health care institutions can reach and be seen as part of the community. That’s another one of our responsibilities as a health care institution: to build that trust through a bridge of people who are already doing the work at the grassroots level.

The Mount Sinai Health System recently launched the Institute for Health Equity Research, which is dedicated to examining the causes and magnitude of health and health care disparities impacting nonwhite, low-income, immigrant, uninsured, LGBTQ+, and other populations across all ages, abilities, and genders. In partnership with local community groups, the Institute is now launching a survey of the health and social impacts of COVID-19. Speak Up on COVID-19: Help Us Help ALL New Yorkers seeks 10,000 respondents across the area.

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