New health chief says drug crisis takes up most of his time; wants to guide kids to make better choices about tobacco, drugs, alcohol

Dr. Hiram Polk

By Melissa Patrick
Kentucky Health News

One of new Public Health Commissioner Hiram Polk’s top priorities is to create an early-childhood education program to help Kentucky’s children become healthy, drug-free adults. But when it comes to smoking bans, not so much.

“I have been on this job for eight to 10 weeks, and I’ve spent more effort on the drug thing than I have on anything else,” he said. “The big-picture issue is to take a long-term look at tobacco, drug and alcohol use and find a way through education to make kids more likely to be immune to that when they grow up.”

Health Secretary Vickie Yates Brown Glisson appointed Polk, 80, of Louisville, after searching for months for a doctor who would take the job. State law requires the commissioner to be a medical doctor.

Polk said he first declined the position, but changed his mind, then told Glisson he would stay only through the 2017 legislative session. However, he said he has since hired a driver, and that this “crucial” decision could very well influence his decision to stay longer.

“What has turned out is that this is a wonderful job,” he said.

His stance on some issues

Polk said that one of the first things he would like to accomplish as health commissioner is to create an education program to teach young children how to live healthy, drug-free lives, and then find a way to set up and fund a foundation to research the outcomes of the program in 10 to 20 years.

“If there is a secret to drug, tobacco and alcohol addiction, it is through very early childhood education. I believe that,” he said.

When asked if he would be willing to promote a statewide smoking ban, which Gov. Matt Bevin opposes, he said he probably wouldn’t.

“I would be willing,” he said, “but it doesn’t have anything like the emotional appeal of some of these other things, like the drug addiction does.”

Also, “I have an idea about drug addiction, but I don’t have an idea of how to do better with tobacco,” Polk said. “If somebody walked in here with a good idea, I’d listen and probably try to implement it, but I just don’t see that happening.”

Smoke-free advocates would likely say they have already offered up a “good idea” to decrease the smoking rate in the state, improve the health of the state’s citizens and save the state an enormous amount of money: a statewide ban on smoking in workplaces.

To this suggestion, Polk reflected on the difficulties in enforcing such a ban, noting that while government property and buildings are now smoke-free in the state, smokers still stand outside.

“I’m not saying it’s not important,” he said. “I think it’s important. It’s vitally important, but there are an awful lot of smart people who have taken a run at that and have failed and I might not try it.”

Kentucky’s smoking rate is 26 percent, second highest in the nation. The national rate is 18 percent. A recent study said that if the state could cut its rate to the national one, it would save an estimated $1.7 billion on health care the following year. Smoking bans and smoke-free policies have been proven to decrease the smoking rate and to protect workers from secondhand smoke. The latest Kentucky Health Issues Poll found that 66 percent of Kentucky adults favor a statewide smoking ban.

When asked if his department would support local health departments in efforts to get local governments to pass smoking bans, he shifted the conversation and said his first priority for local health departments is to re-establish a positive working relationship with them. He said he has recommended the hiring of a new deputy commissioner to work solely on this effort.

“I want to make those local health departments feel like they are connected to us, that we are their friends and they can call on us anytime, any place for help,” he said.

As for mandating the human papilloma virus vaccination, which has been proven to prevent cervical cancer and genital warts, Polk said he supports Gov. Matt Bevin’s stance on minimizing mandates.

“I would try to find every way you can to softly encourage the uniform use of that vaccine,” he said. “But I wouldn’t start requiring something.”

Polk noted that he was very much aware of the state’s rural health issues, having started the first rural surgical education program in America in 1972. But he also said he was surprised by the number of disparities that still exist in Eastern Kentucky.

“I’m surprised by how really under-served and deprived some of the things in Appalachia still are,” he said. “I thought all of these Appalachian programs by now would have had some success, but they are still behind the curve on virtually everything . . . poverty, lack of education, misconduct. It is terrible. There are some problems that aren’t going to be easily solved.”

A new line of work

Polk praised the abilities and the passion of those who work in the Cabinet for Health and Family Services several times during the interview, suggesting they made his job easier.

“I am absolutely amazed at the quality of people who work in the trenches.They are the most altruistic, unselfish people I have ever seen,” he said. Later adding, “The quality of the people and their commitment to the organization, their belief in what they are doing is fairly amazing.”

Polk is an internationally renowned surgeon, but has little background in public health. He described himself as having “always been pretty busy.”

He is a graduate of Harvard Medical School and was chairman and professor of surgery at the University of Louisville from 1971 to 2005, where he trained more than 330 surgical residents and started one of the world’s first hand-transplant programs. He remains a professor emeritus and the surgery department is named for him.

Polk is widely published. He served as editor-in-chief of the American Journal of Surgery for 16 years and was chair of the accrediting body for Surgery in America for seven. He has served as Kentucky chair of the American Cancer Society and serves as a director of the Biomedical Research Foundation, which funds research on veterans’ health. He is a director of the Thoroughbred Owners and Breeders Association and a steward of The Jockey Club.