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DSJ in Conversation with Dr. David Satcher: A Necessary and Critical Conversation to Advance Health Equity

The views expressed are those of the author and do not necessarily reflect the views of ASPA as an organization.

By Vanessa Lopez-Littleton
December 2, 2020 

After a contentious election year, the COVID-19 pandemic, calls for racial justice and efforts to deconstruct the administrative state, a conversation with Dr. David Satcher is both necessary and proper. On Wednesday, December 9, 2020, ASPA Section on Democracy and Social Justice (DSJ) will host a conversation with Dr. Satcher, former U.S. Surgeon General and Assistant Secretary for Health. The discussion will follow an interview format with topics to include: the intersection between public health and public administration, the COVID-19 pandemic, systemic racism, advancing health equity and other topics from Dr. Satcher’s newly released book, My Quest for Health Equity: Notes on Learning While Leading.

Public Administration and Public Health

There are more than 20 million people serving in the United States public sector, including federal, state and local levels. Yet, in the midst of a pandemic, the field of public health continues to experience a workforce shortage. The work of public health centers on efforts to protect and improve the health of individuals and communities where people live, work, learn, worship and age. Politicians and elected officials are often critical of the administrative state and the role of bureaucracy in United States democracy. Yet, the ability of public sector personnel to respond to national threats and crises is paramount. Public sector personnel must be respected and valued for their expertise. Thus, legitimacy and credibility are critical for public sector personnel at all levels of government. This is particularly true for leaders who are charged with leading and managing in a time of crisis.


The COVID-19 pandemic was complicated by a novel virus and the politicization of the United States response. In responding to the novel coronavirus, the lack of a clear distinction between personal protective equipment (PPE) and face coverings contributed to some level of confusion around modes of transmission. This lack of clarity may have allowed for the politicization of face coverings with some arguing that COVID-19 mandates infringe on their individual freedoms. Yet, public health officials must carefully navigate efforts to keep the public safe while minimizing infringement on individual rights.

Systemic Racism

Racism is a controversial concept. The historic and contemporary role of race (and racism as an extension, thereof) play a critical role in shaping the context in which inequities occur. Prior to the Civil Rights Act of 1964, racism and discrimination were blatant. There were clearly marked signs (e.g., whites only, colored to back of bus) to signal how society viewed Black citizens. While the signs may have been removed, policy artifacts combined with other socio-environmental risk factors contribute to differential outcomes experienced by Black, indigenous and people of color (BIPOC). Health inequities are not intractable problems for those who are BIPOC, but impact the whole of society by driving up the cost of healthcare, contributing to inefficiencies in myriad systems and creating delays for those seeking healthcare services.

Advancing Health Equity

In his book, Dr. Satcher shares his personal journey from the civil rights era to his current role as director and senior advisor of the Satcher Health Leadership Institute at Morehouse School of Medicine in Atlanta, GA. Dr. Satcher describes his journey from his first encounter, at the age of two, with injustices in the United States healthcare system. In the Jim Crow South, Dr. Satcher actively fought against oppressive social systems that served as a barrier to access and opportunity for Black Americans. The book is predicated by Dr. Satcher’s three-dimensional perspective of leadership that provides a critical lens for anyone looking to, “Educate, motivate and mobilize,” others to engage in the fight for health equity. The book is a valuable resource for any public service professional looking to contribute to the process of dismantling systemic racism. It focuses on creating the conditions that are necessary for people to achieve good health.


Leaders often have profound stories that define and shape their career. This is also true for Dr. Satcher, whose experience with racism at an early age motivated him to move from, “Victim to confronter to leader.” Dr. Satcher’s life was profoundly influenced by his exposure to leaders such as Dr. Martin Luther King, Jr., Dr. Benjamin Elijah Mays, President of Morehouse College (1940-1967) and many others, including his parents. Dr. Satcher is a highly regarded, well-respected public sector leader who has made an indelible mark on the field of public health. Through his leadership, Dr. Satcher has proven that he not only has the skills, courage and passion to lead in the fight for health equity, but also to influence the next cadre of public sector leaders who are just as committed to advancing health equity as he is.

“We need leaders who care enough, know enough, have the courage to do enough and who will persevere until the job is done.”
~David Satcher, MD, PhD.

Author: Vanessa Lopez-Littleton, Ph.D., RN, is an Associate Professor at California State University, Monterey Bay and Chair of the Health, Human Services, and Public Policy Department. Her research interests include social determinants of health, racial equity, and organizational culture. She may be reached at [email protected], DrVLoLil.Com or @DrVLoLil

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