By Jaymie Baxley
Mandy Cohen, the former head of the N.C. Department of Health and Human Services who is now director of the federal Centers for Disease Control and Prevention, returned to North Carolina Monday for a roundtable discussion about the factors that shape people’s health.
The outcome of yesterday’s election could determine how much the nation focuses on things such as access to transportation, jobs and housing — things that have a larger influence on health care outcomes than realized in the past.
Cohen’s agency, in particular, could be dramatically reshaped by the outcome of the presidential race, which remained undetermined as of Wednesday morning. Anti-vaccine activist Robert F. Kennedy Jr. recently said that former President Donald J. Trump has promised to give him control of public health agencies, including the CDC, if he wins.
Before being appointed by President Joe Biden to direct the CDC, Cohen led North Carolina’s response to the COVID-19 pandemic as secretary of NCDHHS. In that office, she repeatedly advocated for North Carolinians to get vaccinated, and she worked to dispel myths and conspiracy theories about vaccine safety.
A Trump victory could upend the work and structure of the nation’s public health agencies, while a Harris victory could mean that issues such as those social determinants gain more importance in public health work.
Nonetheless, Cohen and her fellow panelists, two of whom are North Carolina Democrats serving in the U.S. House of Representatives, mostly avoided wading into politics during their hour-long conversation.
Progress on health outcomes
One of the main topics of discussion during Monday’s roundtable was a pilot program launched three years ago by the YMCA of the Triangle.
Known as Y Health, the program serves patients who have been diagnosed with pre-diabetes, high blood pressure and other issues that, if left unmanaged, could develop into chronic conditions. After being referred to the program by a physician, the patients receive access to exercise equipment and health coaching services at the YMCA.
Susan Pettengill, vice president of Healthy Living initiatives for YMCA of the Triangle, said most of the nearly 3,700 people participating in Y Health have “achieved tremendous health outcomes.” Half of them lost weight through the program, she said, and 63 percent saw improvement in their blood pressure.
“We launched the pilot with a goal to replicate it statewide and ultimately nationwide,” said Pettengill, who added that there have been “initial medical cost savings based off of preliminary findings” from the program.
“We’re really excited about that,” she said.
The program was created with $2 million in funding from Blue Cross Blue Shield of North Carolina. Christy Colgan, director of strategy for drivers of health for BCBS, said the organization has been satisfied with the results of its investment.
“Health doesn’t happen once you go to the doctor’s office,” she said. “That’s where you go when you’re not feeling well. Health happens here. It happens at the Y. It happens at your local community centers and at home.”
Colgan said Y Health offers different benefits from “going to the doctor’s office or to a class” because participants are “going into a fitness center and learning how to apply what they are learning in a real way.”
“What we are seeing is that people are saving on medical expenses by going through this program,” she said. “We’re really excited about the partnership and where that’s going, and I can’t wait to see what’s next.”
Elizabeth Cuervo Tilson, the state health director and chief medical officer for DHHS, also spoke during the event, giving an update on the state’s Healthy Opportunities Pilot. The first-in-the-nation program uses Medicaid dollars to address participants’ nonmedical health needs — social needs — by providing beneficiaries with things such as housing, food and transportation.
The results of the program, she said, “have greatly exceeded our expectations,” with more than 620,000 services provided to 32,000 people to address social needs across North Carolina since 2022.
“What we’re finding is that when people have lower social needs, they have decreased emergency department visits and decreased hospitalizations, and they save $85 per person per month,” Tilson said. “In health care spending, that’s enormous.”
Election hangs over discussion
The event was held on the eve of Election Day at the YMCA complex in southeast Raleigh, a polling site in the capital city of a key battleground state.
While Cohen did not comment on the possibility of a Trump victory during Monday’s event, she emphasized the important role that the CDC plays in protecting the nation’s health.
“A well-funded CDC allows communities to thrive, but we all need to bring the data and the evidence to show that that money is working well here,” she said. “Fundamentally, it comes back to trust and being proximal to communities. We’re all in this together.”
The need to build trust was echoed by U.S. Rep. Deborah Ross, who on Tuesday won her bid for a second term representing the state’s 2nd Congressional District against Republican challenger Alan Swain, according to complete but unofficial returns from the N.C. State Board of Elections.
“When we have things like four years ago, when we were in the middle of a global pandemic and people needed to know how to have their health care addressed, partnering with DHHS and having people believe that maybe they should get vaccinated, having people believe that they should social distance and wear a mask [was] very, very important,” Ross said during the event.
She added that the House Select Subcommittee on the Coronavirus Pandemic, which she serves on, is scheduled to meet “right after the election to talk about how we prepare for future pandemics.”
The event also included comments from U.S. Rep. Wiley Nickel of District 13, who decided not to seek reelection this year but plans to vie for a seat in the U.S. Senate in 2026. He spoke about his involvement in the newly formed Congressional Dads Caucus, which he said is pushing for legislation that would require employers to offer paid medical leave for families.
“The rest of the world does it,” Nickel said. “It’s time for the U.S. to catch up.”
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