Healthy Communities, Healthy Nations
Shannon Gopaul Balser '01
by Sarah Valente
Long before she stepped into her role as chronic disease division chief for the DC Department of Health, Shannon Gopaul Balser ’01 began to consider what makes for a healthy, equitable society. As a first-generation American with parents hailing from the Caribbean and South America, Shannon grew up traveling, exploring the world, and observing different cultures. She was also keenly interested in math and data from a young age. Did she know that she would follow a career path that melded her interests, experiences, and skills? Shannon confirms, “I’ve always been determined to use my strengths to make my community and the world better.” She notes that the one constant she has carried throughout her career is a propensity to ask important questions, like “What is the need, and how do we address it?” Shannon says, “Ultimately, I ask myself how I can be a vessel of service to improve the individual and collective experience.”
As a student at Potomac, Shannon built on her problem-solving skills. She reflects, “The school environment rewarded that. When I solved a complex problem, I felt acknowledged and encouraged.” After graduation, Shannon went on to Williams College, where she double-majored in economics and American studies. Degree in hand, she headed across the world to apply her skills in Mozambique. Shannon recalls, “My focus at the time was primarily economic. I was studying the impact of the HIV-AIDS epidemic on that nation’s economy.” While there, she discovered her professional passion – the intersection of human behavior, health, and economics.
Over the course of four-and-a-half years in Mozambique, Shannon led a national knowledge/attitudes/practices study examining the effects that HIV-AIDS had on small, medium, and large businesses. She also learned Portuguese – the country’s primary language – and formed deep and lasting friendships. All the while, Shannon was honing in on the behavioral aspects of public health and potential means to promote the health of individuals and communities. She says, “It was a pivotal time for me, both personally and professionally.”
Returning to Washington, DC, Shannon continued to develop her interest in the correlation between behavioral change and public health. She went to work at Howard University, conducting research, earning her master’s degree in public health, and ultimately rising to the position of director of the multimillion-dollar NIH/ NCATS-funded Clinical Translational Science Center – one of only 60 such programs in the United States. The job was both demanding and fulfilling; Shannon and her team of 30 led Howard’s response to the COVID-19 pandemic and helped the university obtain its first-ever clinical vaccine trial. Simultaneously, Shannon was working with the DC government on its response to COVID-19, as a manager for the Department of Health’s Contact Trace Force (CTF). And if that wasn’t enough, she was also raising an active 3-year-old who was just being introduced to online preschool. Shannon says with a rueful laugh, “What a year 2020 was!”
It was her work with CTF that led to Shannon’s current position with the DC Department of Health, a role that seems custom-tailored for her. She observes, “Starting with my time at Potomac, I’ve always been strong in math and science. I love data, and now I’m leading the Chronic Disease Division’s data-driven approach to public health.”
Healing by the Numbers
Shannon is responsible for Washington, DC’s efforts in chronic disease control and prevention. She oversees a team of 12 professionals who delve into data and make programmatic recommendations based on the numbers. Her division leads DC’s chronic disease surveillance programs and develops information dashboards and fact sheets that other government agencies and public-service organizations use as they implement medical and healthy lifestyle initiatives. Shannon points out, “It’s essential for us to disseminate the data we gather in a way that’s appropriate and digestible for our various stakeholders. These include DC residents, community-based organizations, clinicians, and the research community.”
The focus of the Chronic Disease Division’s work is population-based statistics, recording trends in conditions like diabetes, hypertension, and high cholesterol – all risk factors for heart disease and stroke, which are the leading causes of death in DC. Shannon’s team also looks at the top behavioral risk factors that impact chronic disease, like tobacco use and obesity. Importantly, they approach their work through a health equity lens; when they analyze the data, they consider factors like race, gender, neighborhood, and income, looking for pockets of disproportionate health burdens. This method helps the division identify where best to channel the District’s health resources. The team relies heavily on clinicians and community-based partners to be their “eyes and ears” when it comes to amassing crucial data. Among their information sources are health system partners such as federally qualified health clinics and DC hospitals, as well as vital statistics records and Medicare and Medicaid claims. Another important source of data is the annual National Behavioral Risk Factor Surveillance Survey, which is self-reported.
Grassroots Health Literacy
Shannon explains, “There are quite a few social factors that deter healthy behavior. These include lack of access to healthful food, job instability, gun violence, and housing challenges. If someone is hungry or doesn’t have reliable housing, if they feel unsafe where they are or are struggling to find employment or childcare, they are less likely to see a primary care physician and less likely to make healthy decisions.”
While the division does not have face-to-face interaction with DC residents – relying instead on frontline clinicians and community organizations for crucial information – Shannon’s team is working on initiatives that will give residents a greater voice. Examples include partnering with community-based organizations to develop a Health Literacy Initiative and a Social Determinants of Health Screener that will allow the division to track trends and identify gaps in areas like food security, housing, and education. Shannon emphasizes that these projects are less about bringing residents to the table, and more about bringing the table to the residents. By addressing such urgent non-clinical needs, residents can begin to prioritize health. She notes, “When you have community voices helping to shape the programs, policies, and interventions, you have greater buy-in. The process begins to feel authentic and co-created.”
The division is also working on a referral tool that will allow community-based organizations to refer residents to appropriate resources to obtain necessary services. Shannon points out that community organizations are not only a key source of information but also some of the primary users of the division’s data. As an example, she points to her team’s efforts around COVID incidence, the availability of vaccines, and pandemic-related hospitalizations and deaths, noting, “We worked with a variety of organizations to get these important statistics out to the public because we know that having accurate information can lead people to make better health decisions.”
Trust, Collaboration, and Impact
Shannon recognizes that trust in government is low these days; it’s one of the bigger challenges she faces as chief health strategist for the nation’s capital city. She notes, “We collect a lot of data, and whenever the government collects information and the public doesn’t know what it’s being used for, the grey area can feed mistrust.” She and her team are developing a new dashboard that will allow the division to better report on the data they collect. Shannon says, “Our commitment to funneling data back into the community is critical, so that people know it’s being gathered for a positive purpose.” She views increased transparency and community-based health literacy interventions as “game changers for the work that we do.”
Under Shannon’s leadership, the Chronic Disease Division is also expanding its partnerships with community organizations and exploring new resources they have not previously tapped. For example, her division is working with the DC Chamber of Commerce to explore how businesses can create an environment that promotes healthy behaviors, such as providing gym access and having a variety of healthful food choices in the workplace. Shannon is also interested in the idea of teaming up with health-monitoring companies like Fitbit or Apple Health to access aggregated health data that can inform policies to promote physical activity.
Additionally, the division is putting increased focus on systemic policies related to areas like tobacco use, nutrition, and physical activity. Shannon points out that when there are persistent disparities in health, as are seen across the wards of DC, the issues run much deeper than the personal decisions an individual may be making. She explains, “Often, the problem can be traced to something in the environment – the system – that people are functioning in. And you cannot fight systemic challenges with behavior-targeted strategies alone.” Shannon is committed to helping to create policies that lead to a more equitable environment, resulting in improved health outcomes. She says, “The hope is that one day we will not see statistically significant differences in outcomes based on race, gender, or geography…where the risk of developing diabetes is no greater for a Black resident of Ward 8 than it is for a White resident in Ward 3.”
When asked to sum up why public health matters, Shannon’s compassion and logic are both clear. She firmly believes that everyone has the right to lead a heathy, fulfilling, productive life. Further, she recognizes that it is government’s role to protect that right – and that doing so is in the national interest. Shannon asserts, “When our communities aren’t healthy, when there are persisting disparities, it’s a national failure.” She also cites the impact public health has on America’s place in the global economy, pointing to diabetes as an example: “Considering the effects of this widespread chronic disease, we don’t just look at morbidity; we also look at the resulting reduction in productivity, absenteeism, and the increased costs to the clinical community.”
She concludes, “It is in our collective best interest to understand and address the factors – both individual and systemic – that contribute to health challenges in our communities and our nation.”