Who the Health Cares? with Prof Michael Sparer

Public health officials are navigating an increasingly complicated landscape defined by shrinking resources and political polarization. Meanwhile, artificial intelligence is transforming how health systems collect information, manage care and respond to community needs. The challenge for today’s public health leaders is figuring out how to adapt without losing the public’s trust or losing sight of their core mission: improving the health of the communities they serve. 

In this episode, Michael speaks with Dr. Umair Shah, former Secretary of Health for Washington State and former executive director of the Harris County health department in Texas. Drawing on his experience at both the local and state levels, Umair explains how health departments are responding to workforce shortages, shifting federal priorities and the need to function as a safety net provider. He also discusses the growing role of AI in health care and why he believes public health can still serve as a unifying force in a divided country.

The Center for Public Health Systems at Columbia's Mailman School of Public Health conducts needed research, facilitates public discussions, develops policy proposals and provides educational programs, all with the goal of encouraging a better, more efficient and more equitable public health system. This work builds on the recognition that the nation’s public health system is currently under-resourced, under-paid and under-valued, and that a stabilized and strengthened system would benefit all of us.

The work of public health often becomes most visible when our systems are under the greatest strain. From hurricanes to pandemics, crises test not only our ability to respond, but also the strength, flexibility and fairness of the systems we rely on every day. 

In this episode, Michael sits down with Mitch Stripling, Director of the New York City Preparedness and Recovery Institute, to discuss the role of emergency preparedness and response within our public health system. Drawing on decades of experience responding to disasters across the country, Mitch explains how emergency response systems are supposed to work and why they sometimes fail. He also reflects on what the COVID-19 pandemic revealed about our leaders’ ability to respond under uncertainty and the risks and opportunities that come with emerging technologies like AI. 

The Center for Public Health Systems at Columbia's Mailman School of Public Health conducts needed research, facilitates public discussions, develops policy proposals and provides educational programs, all with the goal of encouraging a better, more efficient and more equitable public health system. This work builds on the recognition that the nation’s public health system is currently under-resourced, under-paid and under-valued, and that a stabilized and strengthened system would benefit all of us.

The work of the U.S. public health system is invisible to many of us. That’s why public health guidance is often misunderstood – and ultimately mistrusted – by Americans on both sides of the political aisle. And in times of uncertainty, when clear guidance matters most, the gap between perception and reality is especially costly.

In this episode, Michael speaks with Chelsea Cipriano, Managing Director of the Common Health Coalition. Drawing on her experience at the federal, state and local levels, Chelsea explains how mixed messaging, pandemic-era missteps and a lack of clear storytelling have eroded trust in public health. She also highlights what leaders can do to rebuild trust and find new ways to fund the work that keeps communities healthy.

The Center for Public Health Systems at Columbia's Mailman School of Public Health conducts needed research, facilitates public discussions, develops policy proposals and provides educational programs, all with the goal of encouraging a better, more efficient and more equitable public health system. This work builds on the recognition that the nation’s public health system is currently under-resourced, under-paid and under-valued, and that a stabilized and strengthened system would benefit all of us.

Getting public health messaging right isn’t easy. With trust in institutions on the decline and misinformation on the rise, even life-saving information often fails to reach the people who need it most. So what kinds of messages actually get through?

In this episode, Michael sits down with Dr. Jide Williams, a neurologist and Vice Dean of Community Health at Columbia University. After watching stroke patients arrive too late for effective treatment, Jide partnered with hip hop artist Doug E. Fresh to create a music-driven approach to stroke education. That effort grew into Hip Hop Public Health, a broader model that uses music and storytelling to teach kids about everything from healthy eating habits to the importance of cancer screenings. Jide also explains why music is such a powerful learning tool and what it takes for doctors to rebuild trust with the communities they serve. 

The Center for Public Health Systems at Columbia's Mailman School of Public Health conducts needed research, facilitates public discussions, develops policy proposals and provides educational programs, all with the goal of encouraging a better, more efficient and more equitable public health system. This work builds on the recognition that the nation’s public health system is currently under-resourced, under-paid and under-valued, and that a stabilized and strengthened system would benefit all of us.

Medicaid was never intended to be the backbone of the U.S. public health system. But what started in 1965 as a limited health insurance option for a small group of low-income Americans has grown into a $900 billion program that funds everything from hospital care to housing support. 

In this episode, Michael Sparer and Rebecca Sale trace the history of Medicaid and unpack the sweeping changes coming to the program under the “One Big Beautiful Bill.” The result won’t just be fewer people with insurance. It could also mean unexpected and harmful cuts to the country’s already fragile public health system. They also discuss whether a small, unexpected provision for rural health investment could point toward a better model for the future.

Michael S. Sparer, J.D., Ph.D. is the William Henry Welch Professor of Public Health Systems at Columbia University's Mailman School of Public Health, where he has taught for over 30 years. He also directs the Center for Public Health Systems, which examines how America's fragmented public health infrastructure functions and how it can better serve communities.

Professor Sparer’s research examines how policy shapes politics both in health insurance systems and in local health departments. He is particularly expert in Medicaid policy and in the inter-governmental dynamics that have shaped the evolution of that program. His work on public health has also focused on federalism and on the ways in which local health departments respond to changing political and fiscal environments. Before his academic career, he spent seven years as a litigator for the New York City Law Department. He is a three-time recipient of Columbia teaching excellence awards and former editor of the Journal of Health Politics, Policy and Law.

The Center for Public Health Systems at Columbia's Mailman School of Public Health conducts needed research, facilitates public discussions, develops policy proposals, and provides educational programs, all with the goal of encouraging a better, more efficient, and more equitable public health system. This work builds on the recognition that the nation’s public health system is currently under-resourced, under-paid, and under-valued and that a stabilized and strengthened system would benefit all of us.