After six years as Arizonaβs top public health official, Will Humble stepped down this year and is now hoping to influence health policy in a new role at the University of Arizona.
Humble works most days in Phoenix and spends about one day a week in Tucson, where heβll be teaching a class in public health leadership in the spring of 2016.
The Star sat down with Humble at the UAβs Mel and Enid Zuckerman College of Public Health in Tucson last week. The following are excerpts from the interview:
You spent six years as director of the Arizona Department of Health Services; how long have you been in public health work?
About 25 years. I started my public health career as a restaurant inspector β a public health sanitarian β with Maricopa County and I did that for four years in my 20s. I went back to school and got a masterβs in public health at Berkeley.
When I came back with my masterβs I came to the Arizona Department of Health Services. I worked there from 1992 until March of this year. My first assignment was the Tucson Airport area Superfund site. I worked on risk assessments.
At the UA you are director of health policy and evaluation at the Center for Population Science and Discovery. What does that mean?
I would say our big overarching goal is to use data sets in smart ways to identify strategies to improve outcomes and reduce cost.
In October 2010 the adult dental benefit was removed from the Medicaid package (in Arizona). One of the things we are working on is using the hospital discharge database and the emergency department databases, looking at hospital dental-related emergency department visits.
The whole theory is to use data to inform policy change. Was removing the adult dental benefit penny-wise and pound foolish?
You can do research on anything, but the key thing is doing research that has policy implications.
You overhauled regulation of state facilities?
We went from a prescriptive model to a model that actually puts more responsibility on the licensed facility.
If we go out there and see you have bad outcomes like bedsores, either your policy and procedures were inadequate or you werenβt following what you had or maybe both were bad. The expectation is on the facility to have good outcomes.Youβve got a dynamic regulation that can adjust itself over time, rather than a static regulation that is just stuck at one moment.
Any other major accomplishments you want to mention?
We improved out-of-hospital cardiac arrest survival rates by 300 percent. In 2009, seven percent of people were surviving a cardiac arrest outside the hospital. Now we are in the high 20s.
Arizona basically changed the way the world does CPR with the continued chest compression. We did the pilot study with the city of Phoenix Fire Department and half the people got continuous chest compression CPR and half got the old CPR. We did that study and we actually stopped it early. The results were so profound that it would have been unethical to keep going. So we started giving everyone the new CPR.
What was the most difficult challenge? Was it medical marijuana?
I would say that was the most entertaining challenge. I wouldnβt call it difficult. β¦ I would say the most difficult thing for me personally was what we did around 2009, 2010 and early 2011 around budget cuts.
We ended up, if you set aside the Medicaid match and funds for the (Arizona State) hospital, we cut our state funding about 50 percent as an agency those two years.
We used to have $12 million in funding for underinsured kids so that they could get vaccinated. We cut that to zero. We had a public health laboratory in Tucson we closed. We closed the lab in Flagstaff. Those were really difficult days.
You were active in promoting vaccines for schoolchildren. Would Arizona benefit from prohibiting personal (and religious) vaccination exemptions?
One way to get an American not to do what you want is to tell them they have to do it. Americans donβt like to be told what to do. Arizonans donβt like to be told what to do. There might come a time where there is no alternative, but I donβt think weβre there yet.
