HJNO Jul/Aug 2026

HEALTHCARE JOURNAL OF NEW ORLEANS I  JUL / AUG 2026 13 health department and public health in gen- eral around the country has been to some degree disabled during the pandemic and that’s because a lot of people retired, peo- ple left the department — and health depart- ments all around the country — and building that back now for the kind of health system that we have today has been both challeng- ing and rewarding. We’ve made recruiting for the Louisiana Department of Health an absolute top pri- ority. I think we are winning the battle right now. We’re bringing in some of the best tal- ent that Louisiana has to offer from differ- ent health systems and different health pro- viders that are coming into the government to put their efforts to serve the entire pub- lic. We’ve hired people from Washington, D.C., and other states, who are among the nation’s top performers in their respective disciplines and who are coming here to help make Louisiana a healthier place to live. We still have a long way to go, but I think we’re making incredible progress right now. Editor Public health professionals and people who work in health departments have, in my opinion — and I think in the opinion of many others — always tried to serve the greater good. When politics enters at the top level, how safe do civil servants and public servants feel expressing their professional opinions, especially if those opinions differ from the direction leadership is taking at that moment? Greenstein Yeah. I mean, I would say that — and I’m a public health worker as well — I’m sometimes delighted by the attention that public health gets, because for a long time it was either taken for granted or just not considered a national priority. Right now, we’re calling into question things that were almost a third rail for pub- lic health people, like additives to food, dyes and other ingredients, the overall healthiness of our food, and even our food pyramid. We have spent so long, as pub- lic health people, fighting against having bad food in our food supply and trying to address what it causes for people in terms of chronic disease. And now that issue is front and center. I think it’s almost as if we have won the battle of trying to convince political leader- ship and theAmerican people that all these elements make a big difference in how healthy we can be. So I’m pretty enthused about the attention a lot of this gets. And I think, for public health people who are deep in the bureaucracy, we’re lucky to have such expertise and such hardworking people. My goal is to not let politics get in the way of doing those core public health functions in our state. Editor The surgeon general’s role has been significantly elevated in Louisiana. At the same time, many pediatricians, epidemiologists, and public health professionals are concerned that the state is moving away from the traditional public health consensus on vaccines. How do you build trust in the public health when many of the experts disagree with the decision the state appears to be taking? Greenstein Well, actually I’m not sure. I don’t agree. I think that our vaccine policies have been pretty consistent along the way. There’s been a lot of just discussion publicly, but when it comes down to the actual decisions or guidance or what we reimburse for, which are our regulatory authorities, there’s really been little or no change. Editor I guess the change is the lack of promotion of the vaccines from the department, and then the kindergarten MMR coverage has fallen below 95%, which is concerning to many. Greenstein Yeah, this is where our primary care physicians and pediatricians have a responsibility to work with parents around the state. If anything, our guidance is that there are decisions that should be made between the healthcare provider and the parent and [we are] asking them to step up and work with all of their patients to make sure they get what is clinically necessary. Editor Do you think those shots are clinically unnecessary? Greenstein Oh, I think there are many, many shots, so each of them have their own specific sets of guidance. Editor Is that a public health concern that the kindergarten rate has dropped below 95%? Greenstein I would say that there’s two ways to look at it. One is there a philosophical concern, and then the other is, what is the data showing so far?We don’t have massive outbreaks, or even small outbreaks, so the data is not showing that the public health is suffering right now. When it comes down to a belief system, I leave that up to clinicians and national panels and our state clinical policy makers to determine.