Lisa Hernandez begins her tenure as Santa Cruz County health officer July 5.
(Via Lisa Hernandez)
Health & Wellness

New Santa Cruz County health officer Lisa Hernandez on how data can help solve our biggest health challenges

After working in obstetrics and gynecology for four years, Lisa Hernandez soon realized that she had a true passion for addressing public health at the community level. Since then, she has worked in a number of public health positions, including a three year stint in Santa Cruz County from 2013 to 2016. Now, she returns as health officer. Lookout caught up with her ahead of her first day on the job.

Completing one medical residency is daunting enough, so it’s clear Lisa Hernandez had a strong drive for public health when she decided to complete a second residency in preventive medicine after four years practicing obstetrics and gynecology.

After earning a doctorate of medicine from Georgetown University in Washington, D.C., Hernandez and another classmate worked on a project in the city called the Service Learning Project — a health and physical education initiative in a D.C. school that still continues today. That experience directly led to her second residency in preventive medicine at UC San Francisco. Eventually she realized her true passion was working at the community level.

“It brought me back to a lecture I had in one of the classes where a doctor came in and inspired us to realize that our white coats really could be used for advocacy and caring for the community,” said Hernandez, who starts Wednesday as Santa Cruz County’s new public health officer. She takes over from Gail Newel, who retired in June.

Hernandez has held numerous high-ranking public health positions in the Bay Area and Central Coast, including a stint of more than three years as Santa Cruz County health officer and Health Services Agency director from 2013 to 2016.

She comes to Santa Cruz after more than five years as the City of Berkeley’s Public Health Officer, where she was a major player in the city’s pandemic response, using citywide vaccination data to identify pockets of low uptake and ensure that the most vulnerable populations were getting vaccinated.

She believes in an approach that combines data analysis with community outreach to develop a thorough, holistic view of community health. “Drilling down the data is really important,” she said, adding: “But we also need to understand people’s lived experiences.”

Though her previous time in Santa Cruz County was nearly a decade and a pandemic ago, she says that communitywide issues are similar to what they were back then — mental health, the opioid crisis and homelessness — but heightened.

Lookout spoke with Hernandez ahead of her first day on the job to discuss the differences between the states of Berkeley and Santa Cruz public health, the lingering effects of the pandemic, and how the affordability crisis has impacted community health.

This interview has been edited for brevity and clarity.

Lookout: What drew you to taking a role addressing health at the community level rather than the individual level?

Lisa Hernandez: They’re very much linked — we’re addressing the same issues just from different perspectives and sometimes with different tools. One of the things that drew me to public health was the ability to do more prevention work. An analogy is like if people are drowning, the physician’s role is [to be] the person that pulls them out of the water and saves them. The public health official is the person who looks at why people are falling into that situation and how it can be avoided.

We need both. We have similar roles in terms of saving that person or people, but we’re just looking at it and addressing things from a different perspective.

Lookout: How has Santa Cruz County’s public health landscape changed since your previous stint?

Hernandez: We’ll see if what I say today is still the same in two months, but that said, I think a lot of the issues that communities are experiencing have just been heightened. We’re just coming out of a pandemic that really impacted all of us and the issues I see in Santa Cruz that I think look a bit greater now are the behavioral and mental health needs in the community. I also think that, specifically in our youth, it’s a big issue and greater now than it was pre-pandemic.

The other thing is health equity. One of the first things that I know I’ll be working on is the community health assessment and health improvement plan for the county. That assessment allows us to work with the community to understand what their concerns are and partner with community-based organizations to leverage their work with us to improve the social determinants of health and, ultimately, the health of the community.

Last but not least, the opioid crisis is something that still continues and has heightened during and after the pandemic.

Naloxone, used to treat narcotic overdoses, are seen at a safe injection site
A small but attention-grabbing proposal in Gov. Gavin Newsom’s budget would pay for providing naloxone, which reverses opioid overdoses, to every middle and high school in California.
(Kent Nishimura / Los Angeles Times)

Lookout: So did you deal with drug prevention during your last tenure in the county?

Hernandez: One of the first things I worked on as a health officer here was on the syringe exchange program. That was a big, big effort that started during my first tenure as we were working on strengthening the crossing of work between the public health division and behavioral health.

Lookout: Your bio says that you have an affinity for data-driven solutions. How do you hope to improve or implement that here?

Hernandez: We should always use data to help us understand our needs, successes, and where to focus next. We need to use the data we have, whether it’s vaccination data, case data, or information about dealing with tobacco cessation to help us improve our programs. But we also need to understand people’s lived experiences, so that qualitative data we get from speaking to the community is extremely important. So I think trying to understand how those two mesh and use that to help us improve our services is something I’d like to see as I start working in Santa Cruz. That community health assessment will help us do that, too.

I’ll give an example of during the pandemic in Berkeley: We looked at our vaccination data to see who we weren’t reaching. We realized that we weren’t doing a good job of vaccinating African American and Asian American seniors. Berkeley has a great vaccination rate — upwards of 94% of the population has their primary series — but then drilling down the data is really important. You can see where to improve and where there’s opportunity to ensure that we have better outcomes for people.

A child receives a COVID-19 vaccine
Christian Loza, 7, left, receives a vaccination from Christopher King at a Kaiser Permanente clinic in Tustin on Nov. 4.
(Francine Orr / Los Angeles Times)

Lookout: As you’re readying to leave your position in Berkeley, how does the state of public health in Berkeley compare to that of Santa Cruz County?

Hernandez: For one, Berkeley is like 120,000 people and Santa Cruz County is 260,000 people, and that’s a definite difference. The Latino population is greater in Santa Cruz than in Berkeley, and while both have UCs, Berkeley’s student population is about a third of our city population and that really changed the dynamics of the community. While Santa Cruz’s definitely impacts the community, too, it’s a little different than in Berkeley because it’s smaller. We have Sutter, Dignity, and now Kaiser. We only have one hospital in the City of Berkeley, which definitely impacts health. I think back on working a little more closely with the health care providers as a highlight of my previous time in Santa Cruz.

On similarities, I think both communities have engaged community-based organizations and partners, so in Santa Cruz I’m looking to explore that again and re-establish that presence.

Lookout: The affordability crisis is very real in just about every major urban area in the country. How has that affected the state of public health?

An unhoused individual stands outside his tent in a section of Pogonip that was not yet slated to be cleared out on June 5.
An unhoused individual stands outside his tent in a section of Pogonip that was not yet slated to be cleared out on Monday, June 5. In the foreground is the remains of a campsite that was within the area that was cleared out early Monday morning.
(Kevin Painchaud / Lookout Santa Cruz)

Hernandez: Berkeley is in Alameda County, and when you look at Alameda County, Berkeley is number two in homeless rate per capita behind Oakland. The link between homelessness and public health is critical, and instead of looking at it outside of a communicable disease perspective, I’m going to look at it from a broader perspective. As a whole, unsheltered individuals have a life expectancy that’s cut short by at least 20 years due to quality of life, lack of access to care, and the stress of being unsheltered.

I think we’re going to see more problems as the affordability of housing gets worse. We’ll see health care access diminish, more chronic illness, hypertension, diabetes, depression, and substance use. It’s sort of a ripple effect that we have to deal with. Housing affordability is definitely a public health issue that we have to consider as we address health in our community.