Kathleen Gilligan Sebelius ’70: Advancing the Health of the Nation
by Judy Cabassa Tart ’78
The U.S. Department of Health and Human Services (HHS) represents almost a quarter of all federal expenditures and it administers more grant dollars than all other federal agencies combined. Medicare, which falls within its jurisdiction, provides health care insurance for one-quarter of the population of the United States. Coupled with the fact that the agency covers a broad range of issues affecting daily life (think food safety, disease prevention, H1N1 flu vaccines, AIDS research, obesity, tobacco use and teen pregnancy just for starters), you might wonder who would be willing to take on the myriad challenges of leading a behemoth like HHS. It’s no surprise that the secretary of Health and Human Services is a Trinity woman.
Public service is not new to Kathleen Gilligan Sebelius ’70. She is the daughter of a former governor of Ohio, John Gilligan, but has an extensive track record of her own to offer. She was a member of the Kansas House of Representatives from 1987 to 1995, and then became the first Democrat to be elected Kansas insurance commissioner. Governing magazine elected her as its Public Official of the Year for 2000, thanks in part to her advocacy for consumer rights and her sharp attention to fiscal policy. With her election as governor of Kansas in 2003, the first Democrat to win a state-wide election in Kansas in 60 years, she became the country’s first daughter of a governor to be elected governor. During her term she stressed issues such as affordable health care and education, a foreshadowing of her cabinet post. In 2005, she was named one of America’s Top Five Governors by Time magazine, a tribute to her dedication and public service. She was re-elected to a second term in 2006. She was sworn in as secretary of HHS in 2009, and in 2010, Modern Healthcare magazine named her America’s second most powerful person in health care.
These are challenging times for the Department of Health and Human Services, as the country aims to react to global and national crises while developing a multi-pronged approach to improving the health of all Americans. At the time that Sebelius came to the agency, the country was focused on a possible pandemic of the H1N1 virus and calls for health care reform legislation. In fact, immediately following her swearing-in as secretary, she was whisked off to the White House Situation Room for a briefing on H1N1.
Just one week later, she spoke about the critical need for dispatching updated information through all available technologies: “My colleague Secretary Napolitano and I have held multiple briefings for members of the media and, last week, we hosted a webcast that gave the 76,000 Americans who participated the chance to learn more about this virus. And we have regularly briefed state and local officials about the steps they can take to protect their communities. We recognize that clear, accurate information is essential in times like these, and we are committed to communicating directly with the public.”
In her first days as secretary, Sebelius addressed the World Health Organization in Geneva, Switzerland, saying, “Our world demands a new, integrated approach to public health – one that seeks to understand and target the many factors that can threaten the lives and livelihoods of all our citizens.” Those words rang true with two eminent challenges, including the Gulf Coast oil spill that affected families, the environment and our food supply, and Haiti’s devastating earthquake that spawned a cholera outbreak with possible global implications.
Response to crises must be balanced with the ongoing work of the agency that occupies staffers on a daily and weekly basis. Passage of the Affordable Care Act has brought a stream of changes to nearly every aspect of our lives, from health care and health insurance to issues relating to the food supply and nutrition, which in turn affect our health. As the leader of HHS, Sebelius must ensure that all facets of this new challenge are met. As one aide summed it up, a typical week’s schedule for the secretary might include “travel to three different states, testifying on the Hill, a call with the president, and a dozen internal briefings.”
Last November, Sebelius was invited to speak at Kansas State University, as part of the prestigious Landon Lecture series. Named for former governor and presidential candidate Alf M. Landon, the series was established to provide a forum for prominent public figures to speak about current issues. As she spoke, Sebelius ticked off several “reforms, investments and technologies” that serve to illustrate some of the challenges and achievements of the government’s largest non-military department. Among them:
A review of the process to develop medical countermeasures – “vaccines, antivirals, diagnostics and other drugs and equipment that are often our first and best defense against these threats.” Countermeasures are vitally important to our safety and well-being, but also extremely costly to develop. HHS is exploring the possibility of creating a nonprofit venture fund that could defray associated research costs that might otherwise be prohibitive for small companies with great ideas, thereby stimulating more research that will produce greater results that benefit everyone.
The Cancer Genome Atlas: This comprehensive database located at the National Institutes of Health (NIH) houses DNA changes related to 20 different major tumor types, facilitating highly targeted research on the most prevalent types of cancers in an effort to improve treatment efficacy.
Improved health care delivery: From the sharing of best practices relating to health care epidemiology to increased use of electronic medical records that provide complete and accurate transmission of personal medical histories to inform health professionals’ treatment of patients, the system needs help to implement change on a national level. HHS has created Health IT Regional Extension Centers designed to provide technical support to a wide range of health professionals so that they can share and implement innovative ideas and techniques.
A broad agenda to implement programs that directly relate to Americans’ health and the increasing problem of obesity among both adults and children. As part of First Lady Michelle Obama’s “Let’s Move” initiative, HHS is working to increase consumer knowledge of prepared foods served in certain chain restaurants and to help local farmers and food providers to reach greater markets. An increase in healthy food choices means that people can make informed choices and reduce health risks such as diabetes, high blood pressure and heart disease, conditions often related to poor diet.
The health of Americans is a priority for the Obama Administration. Speaking before the U.S. Department of Agriculture, Sebelius noted, “The obesity epidemic carries steep costs. Obesity brings a far higher risk of heart disease, stroke and certain cancers. Chronic diseases like these account for 7 in 10 deaths in America and three-quarters of our nation’s health care costs. These costs weigh heavily on local businesses and state budgets – but also on our ability to grow and innovate as a nation. That’s why this administration has launched a broad agenda to help Americans get healthy, stay well and thrive.”
Tackling the issue of obesity requires actions that illustrate the broad spectrum of HHS work, from health care and medical treatment to food safety and nutrition. To be truly effective, programs must look at root causes as well as factors that add to the problems for a population in which two-thirds of adults are overweight or obese, and one in three children is overweight or obese.
One starting point is improved health care coverage. The Affordable Care Act allows for greater access to preventive health measures by eliminating co-payments that were previously associated with these services. Something as simple as an annual wellness check can provide the opportunity to reinforce healthy lifestyle habits or identify less desirable practices and dietary concerns. In a recent speech to pediatricians, Sebelius spoke of her initiative called the “Connecting Children to Coverage Challenge,” in which she called on everyone from governors to high school coaches to work to ensure that children are enrolled in available health care programs. HHS is also working with health care professionals in their communities to implement incentives that will encourage participation in healthy lifestyle programs.
Educating the public about food may seem obvious, but we live in a society where access to food choices is outside the control of many people. Prepared frozen dinners and fast food restaurants provide a steady diet for people on the go or families racing to get to after school activities. How can consumers know which foods to choose if they are not fully aware of the nutritional content of their choices? Under Sebelius’ leadership, HHS is overseeing new initiatives to require many fast food chains and vending machines to list the type of nutritional data that has become standard on supermarket shelves. As Sebelius noted in a commencement speech at Columbia University Mailman School of Public Health, “We know that one of the biggest keys to staying healthy is eating a nutritious diet. And we also know there are lots of obstacles to doing that, from neighborhoods with no grocery stores to the lack of nutrition in some school meals. But one of the biggest obstacles to eating healthy is knowing which foods are healthiest. We all know that fresh fruits and vegetables are better than French fries. But how many of us would guess that a tuna melt sub at a fast food chain can have more fat than a stick of butter? Or that an individual pizza at some restaurants can have as much fat as 45 sticks of bacon?”
HHS is also working in conjunction with the Department of Agriculture to ensure that school breakfast and lunch programs incorporate more fresh foods, whole grains and produce in their menus, so that student access to food results in smarter choices than high-calorie sodas, chips and candy. This type of partnership between agencies is unprecedented, and has been very positively received.
Education is one thing, access is another. HHS is committed to working with local communities in order to bring local farmers’ produce to families who can then access fresh, healthy choices. The more families who can patronize small farmers, the more success these farmers enjoy, and the stronger their businesses become to support the public demand. Proximity to fresh food and healthy choices means better health for Americans, making them less likely to require frequent doctor visits and medications for conditions like diabetes, heart disease and high blood pressure.
Key to these strategies is the realization that the government cannot legislate healthy lifestyles. Communities must become involved and must find solutions that encourage and facilitate smart choices and best practices. HHS funding through the Recovery Act has made many innovative programs possible that do just that. Two examples: establishment of community gardens in low-income Boston neighborhoods to provide fresh produce to inner-city residents living far from farmlands; and a partnership between schools in the Jemez Pueblo tribal nation in New Mexico with local farmers to make local produce part of a healthier school lunch or breakfast. These are just part of a larger strategy called “Communities Putting Prevention to Work.” It would seem that the work of HHS has many starting points that must converge to create success.
Sebelius heads an agency that is trying to meet the challenge of improving lives and reducing costs. Perhaps her priorities regarding the strategic goals of HHS illustrate the demands most aptly: “This is an exciting time for the U.S. Department of Health and Human Services. Whether it’s providing millions of children, families and seniors with access to high-quality health care, helping people find jobs and parents find quality child care, keeping the food on Americans’ shelves safe and infectious diseases at bay, or exploring new frontiers of biomedical research, we are working every day to give Americans the building blocks they need to live healthy, successful lives.
“To achieve these goals, we must always keep an eye on the future – to prepare for the next public health emergency, to pursue the next lifesaving cure, and to support the development of the next generation of Americans. But we must also frequently look closer at old programs and existing services and ask: What needs to be changed? How can we serve Americans better? What can be done faster, less expensively and with higher quality and greater transparency?”
These are certainly demanding times, and Sebelius and her team are committed to leaving a lasting legacy for the future health and security of our nation.
So often we ask, “Why Trinity?” In the case of Secretary Sebelius, Trinity may have been inevitable.
Sebelius was a product of single-sex schools, and very much enjoyed that experience. “It was familiar. I liked it.” As it turned out, in the 1960s all the top colleges admitting women were also women’s colleges, and the Ivy Leagues were for men only, so choosing a women’s institution was not purposeful in and of itself. She did, however, already understand that an “all girls” atmosphere underscores the importance of forming friendships with other women.
She was very interested in studying in Washington, D.C., but with a brother already at Harvard, her family encouraged her to make the tour of Boston. Trinity had the geographic edge, and also was alma mater to her father’s twin sisters. As she entered college in 1966, her father was running for the U.S. House of Representatives. He later served as governor of Ohio. With politics seeming to be in her genes, Sebelius chose Trinity.
As luck would have it, her entrance to college in 1966 coincided with a hometown visit from Robert F. Kennedy, who was lending support to her father’s congressional campaign. It was an event not to be missed, but after a brief opportunity to witness history that Sunday, Sebelius was whisked to the airport by a campaign aide she did not know, baggage in tow, and sent off to college in Washington alone while her family stayed behind to host Kennedy.
At Trinity she made friendships that she still treasures today. Perhaps strongest among them is her friendship with Peggy Hoffman O’Brien ’69, former president of the Alumnae Association and also former chair of Trinity’s Board of Trustees. She remembers O’Brien as “full of life, warm, funny – and she was a year older. She had done everything and could lead the way.” They hit it off from the start, and Sebelius characterizes O’Brien as “very much of a soul sister.”
Her four years at Trinity came at a “tumultuous and lively period” for Washington, beginning in fall of 1966 until spring of 1970. Those four years saw the riots that followed the assassination of Dr. Martin Luther King, Jr., as well as growing opposition to the Vietnam War and a plethora of anti-war demonstrations. Her family had instilled in her a moral compass that directed her to continue to do good work and to do good, and Trinity reinforced that ethic. She reflects, “It would be hard to be in college in D.C. at that time and not be engaged in cutting-edge political events.… The social consciousness of the ’60s led to community involvement” that still drives her work today.
Sebelius has returned to Trinity’s campus many times, including once as governor of Kansas, and most recently, as secretary of HHS, to address the Class of 2014 at its orientation last August. In her remarks to students, she noted, “Trinity is a great place to be. It is a life-changing experience to attend Trinity and be part of this amazing community. I wouldn’t be in the job I’m in and I wouldn’t be able to do the job without the incredible education I received at Trinity and the lifelong friends I made here. I still look to my Trinity friends for counsel and advice.” There is perhaps a bit of pride and celebration as she notes the changes and the constancy of mission: “I am extraordinarily impressed with the remake of Trinity. Trinity fills an important niche, educating women for the future, particularly returning students.” She notes the robust enrollment, the relevance and connection to the Washington community, and the incredible opportunities that Trinity still affords women. “Trinity is stunningly impressive.”