An Ounce of Policy is Worth a Pound of Cure

Dr. Karen Aletha Maybank always knew she would become a physician— even before her 6th birthday, when she received her first doctor’s kit.  

“I always knew I would grow up and become a doctor, because I always wanted to heal sick people,” she said.  

Today, the young Maybank is board-certified in pediatrics, preventive medicine and public health. She is the assistant commissioner at the New York City Department of Health and Mental Hygiene and serves as the director of the Brooklyn District Public Health Office, located 485 Throop Avenue between Putnam and Madison Avenues in Bedford-Stuyvesant.

However, what Dr. Maybank didn’t know back then – and would never have guessed – is that practicing medicine in a hospital setting was not her calling.

But it didn't take her very long to figure it out: While completing her residency in the neo-natal intensive care unit at Columbia University Hospital, Dr. Maybank began to grow frustrated, unfulfilled. 

“It felt boring to me to do medicine,” admitted Dr. Maybank. “It felt monotonous to be in such a sterile, stiff office environment. It just didn’t fit with my personality.”

Also, she added, it was a huge challenge to be able to discuss inequities in health beyond anything clinical. That is, how race and culture can influence an entire community's health.  

“Because when people come to you, they come to you with all of this behind them,” said Karen waving her hands in a big circle. “And if you don’t figure out or have an understanding of what the 'all of this behind them' is, I think it’s very difficult to treat anyone effectively.”  

Dr. Maybank felt a growing urgency to have that conversation, something she refers to as the “upstream factor.”  

“Imagine you’re in a camp, and you’re at the bottom of this stream, and you’re discovering all of these sick and dying babies downstream,” said Dr. Maybank. “People will think, ‘what’s wrong with all these babies?’  

“You can spin your wheels trying to save all these babies’ lives after they’re sick. Or you can try to figure out the root of the problem by going upstream. Racism, housing, education, all of these other things influence what’s really going on downstream. But these types of conversations are much more difficult.”  

She believed policy was the only way to adequately address health issues on a larger level, a conclusion that began to lead her away from clinical work toward community health advocacy. After completing her residency, Dr. Maybank left clinical medicine and moved to Long Island.

The Suffolk County health commissioner at the time happened to be an African American, and he wanted to start an office of minority health. He invited Dr. Maybank to come on board. She also received the blessing of Steve Levy, the county executive.

And in 2005, Dr. Maybank co-founded the county’s first office of minority health in Suffolk County. The office is only the second office of its kind in New York State, and now involves more than 50 community stakeholders all interested in improving the health outcomes of minority communities in Suffolk County.

Dr. Maybank, a Clinton Hill resident, headed up the Suffolk County office for three years, before accepting her current position in 2009 as the director of the Brooklyn District Public Health Office in Bed-Stuy.

“It was an hour and a half commute each way, and I wanted to be closer to home,” she said.

She says she enjoys what she’s doing at the public health office, because her day has a lot of variety. She meets with local community boards, is heavily involved with policy, gives presentations, writes recommendations and gets to interface directly with residents.  

Under Dr. Maybank’s watch, the District Health Department has begun to build a host of partnerships with the Department of Education working with public schools in Brownsville and East New York. There’s a new and comprehensive DOE Wellness policy the department is trying to implement across the board around the city to broker environmental and system changes in healthy food choices in and outside of schools.  

“Low-income communities have so many competing priorities, it’s hard to get people’s attention, so we’re trying to provide some technical assistance on implementing the details of the wellness policy with principals,” said Dr. Maybank.  

“Obesity is the biggest thing we’re focusing on now. It’s an epidemic. It’s again implementing policies that affect product placement and so that when you walk into a bodega, the first thing you see is not potato chips or soda. You walk in and see fruits, nuts and vegetables. Slowly, we want the default choice to become the natural choice.”  

There’s also a big push for decreasing the supplies of sugar-sweetened beverages. Additionally, the office has a local level research unit, so they can find lower level processes.

The latest report addresses bike lanes and active transportation initiatives: “This report is one of my favorites, because we need to promote active transportation,” she said. “We’ve placed four cameras in Bed-Stuy to study pedestrian and motorists’ behaviors around bike lanes to see what is actually happening.”  

Dr. Karen Aletha Maybank is every bit hopeful that eventually, the community will begin to turn its health around. Since she was a little girl, she always believed in unlimited possibilities.  

“I think I get that from my mother. My family is from the Caribbean where your limitations aren’t necessarily because of racial or social inequities. Your doctors, lawyers, professors, everyone is black, so you don’t think in terms of limitations because of the color of your skin.  

“I truly believe, as a community, we can overcome whatever perceived limitations are in front of us,” said Dr. Maybank. “We can do it. But real talk within our community is important. Real talk.”