NYC top doctor’s priorities: health, affordability, and then there’s Trump

Mayor Zohran Mamdani, in announcing his pick for New York City health commissioner, praised Dr. Alister Martin as someone with “extensive experience on the frontlines of public health.”

If the past is a prelude, Martin will have opportunity to call on every ounce of that experience in leading the city’s sprawling Department of Health and Mental Hygiene, which has 7,000 employees and an annual budget of $1.6 billion.

The agency is responsible for managing clinic services and public health emergencies — think of the AIDS epidemic, Legionnaire’s disease and COVID-19. It inspects child care centers and restaurants, and issues birth and death certificates, among sundry other tasks.

Martin, an emergency room physician and assistant professor at Harvard Medical School, previously served as a White House fellow and on an advisory panel to the U.S. Department of Health and Human Services on outreach to low-income communities.

Martin recently discussed his new role with “All Things Considered” host Sean Carlson. Here is a lightly edited transcript of their conversation.

What should New Yorkers know about your background?

I’m a Queens kid at heart. I was born in Jackson Heights, just a couple of miles up the street from where I work now, in Long Island City, in Gotham. I began my medical career in Boston. I came back home to try and do the work that we can do to push the agenda of this administration forward and to keep New Yorkers safe and healthy. I’m so excited to be able to do that.

What do you think that did to prepare you for this role?

Well, I’ll tell you what, at the end of the day, the ER really is the ground zero for public health crises. You think about people who are dealing with addiction, who are coming in after overdose. Folks who are coming in with nowhere else to go, dealing with homelessness. They are simply there because they haven’t eaten a warm meal in a couple of days. You can only see so much of that before you decide to act, before you decide to get in the game and try and make those changes.

And I’ve spent my whole professional career creating programs, at the nonprofit level, as a nonprofit executive trying to make an impact on those issues. And then I went to the highest levels of government working at the White House, to continue to make an impact on those issues. And I’m excited to bring those skills right here to the city that I was born in.

Let’s talk about your priorities as commissioners or an overarching theme.

The three big priorities for me are number one, first and foremost, keeping New Yorkers safe and healthy, and doing that in an era where the federal government, quite frankly, is stepping back. So we are gonna step up and do the work that we need to do to protect New Yorkers.

The second priority for us is to really advance the affordability agenda. I think that we have so much that we can do from the public health perspective on that.

And the third priority is just making the work that we do in this department more visible. I think so many people just think of us as the agency responsible for the blue letter grades in front of restaurants. Yes, we do that, and it’s an incredible service, and we do so much more than that. So it’s gonna be my job to lift up some of those stories.

Are there any specific initiatives or, let’s say, breaks from past practices that you plan on initiating?

We really want to take a hard look at what exactly the interventions are that we are gonna to be able to address on affordability. As a health department, we don’t have the final say on addressing health care affordability. But there are a couple of things we can do to make a meaningful impact. The federal policies are gonna change when it comes to Medicaid, starting Jan. 1, 2027. Folks are gonna get bumped off their Medicaid because of silly procedural things — like someone getting a piece of mail to update their Medicaid and it goes to an old address, or not getting their work requirements done. We as a health department are gonna make sure that people stay covered, stay on their Medicaid, and continue to get the care that they need.

We’re gonna also try and continue to do the work of erasing medical debt. Our department has erased over $135 million in medical debt. I want to really take a look at scaling that. And there’s a lot of other work that we can do around helping folks reclaim the benefits that they’re owed — with things like SNAP, WIC, Lifeline, EITC. Billions of dollars every single year get left on the table because people are not enrolling in these programs. And I think we can help our agency co-partners bring those folks into the pipeline.

Now, you talked a lot about affordability and that kind of leads into something we wanted to ask you about. When people talk about public health in New York City, disparities between the haves and have nots usually come to mind. What plans are in the works to level the playing field, so to speak and deal with those disparities?

First and foremost, this department has a commitment towards pushing forward the work of health equity. And we’re doing so in an era where the federal government has quite frankly made it dangerous to do that. They’ve threatened – and in some cases have actually gone through with — to cut our funding. And guess what? We fought back. We went to court and we were able to get some of, get all of that funding back to continue to do the work that keeps New Yorkers safe and healthy.

So the bottom line is this, at the end of the day, when it becomes hard to do this equity work is when you begin to see who really means it. And this department really means it. And we will continue to stand by our commitments on health equity and demonstrate what leadership looks like across the nation on that.

Last year there were sometimes different health recommendations coming from the federal government and the city health department, particularly with regard to vaccination. How do you imagine the relationship between your department and federal policymakers playing out?

We have to be honest with what we’re seeing here, and that is that the federal government is stepping back in a big way. And in many cases, they’re propagating misinformation, inaccuracies, and they’re just leading to this era of confusion that folks are living through right now.

What we are gonna do for New Yorkers is make sure that they have the correct public health guidance, the correct vaccine guidance, the correct public health education. And we’re gonna work with the places where trust is highest, working with our community-based partners, working with the pediatricians that have some of the most important relationships with families to make sure that they get the information they need to make decisions on vaccines. That is the day in, day out work of this department, and I’m excited to keep that drumbeat going.

Under President Donald Trump there’s been upheaval at the Centers for Disease Control and Prevention, and the United States has pulled out of the World Health Organization. What does that mean for the health of New Yorkers?

What it means for us is that we cannot wait anymore for the federal government to come in and tell us what’s right and what’s wrong. What it means is that we’ve got to rely on ourselves. And, you know, we’ve got in our department some of the brightest minds in public health, who we are leveraging to really guide the way forward. But it also means relying on our regional partners.

Last year we joined the Northeast Public Health Collaborative, which is a consortium of different states and cities that are working together on best practices around public health guidance. But it also means taking bold steps like you saw us do just a couple weeks ago, joining the World Health Organization as a city — the first major city to do that. And so you’re gonna see us continue to lead, because that’s what we do as New Yorkers.

Your predecessors have faced all manner of challenges – like the AIDS epidemic, COVID, Legionnaire’s outbreaks, yellow fever. Are there any specific lessons you’ve learned from those experiences?

I’m in constant communication with my predecessors. Some of us are on a group chat. It’s so important to connect with the people who have been in the seat. And I think it’s really important for me to listen and learn. Of course the experiences are different, and the context is different, but there are so many commonalities, and it’s an honor and a privilege for me to be able to have them as a resource, to help me guide in this critical time. Our department’s been around for 220 years. And we’ve seen crises. You know, what’s happening at the federal level is shocking, quite frankly. And guess what? This department has survived, has thrived, and has led through crisis, and I’m excited to lead us through this one, too.

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