Karen Hacker reflects on tenure as Allegheny County Health Department director

After six years of working to rebuild the Allegheny County Health Department, Dr. Karen Hacker departs with the hope that the county is better equipped to continue work in areas like air quality, combating the opioid crisis and studying health inequities among residents.

“I do feel that I’m leaving the department in a much better place than it was when I arrived, and I feel that the next person has a great foundation to build off of,” she said, counting restructuring the department as one of her biggest achievements as its director.

Hacker took a job as director of the National Center for Chronic Disease Prevention and Health Promotion. It is part of the Centers for Disease Control and Prevention, based in Atlanta.

She previously led the Institute for Community Health as a professor at Harvard University. She joined the Allegheny County Health Department in 2013 to replace Bruce Dixon, who led the department — which handles a wide range of issues including air quality, plumbing, infectious diseases and restaurant inspections — since 1992.

“She really transformed every one of those areas and improved them, brought in some folks who really helped the department and also encouraged and motivated those who were already there to do a better job,” County Executive Rich Fitzgerald said of Hacker’s tenure.

Dixon was among several county department heads ousted during Fitzgerald’s first year in office. He later sued over his removal but died in February 2013, before the lawsuit was resolved.

The department still employs about 400 people, but, since Hacker was hired in 2013, about two-thirds of the staff has been replaced, she said.

She worked to expand the the department’s capacity for data analysis in order to better study health inequalities across the county and increased staff focused on studying chronic diseases, she said.

“We know that the eastern part of our county is just not in the same health outcome state as the western part of our county,” Hacker said.

Health disparities between white and black residents are still prominent as well, she said. She hopes it’s an issue her successor will continue to study.

Hacker’s successor will also face the ongoing opioid crisis.

Changes also included expanding the department’s legal team to six members. The move helped the department take a stronger stance on issues related to air quality and polluters like U.S. Steel.

“I think it is a turning point,” Hacker said, looking back on the past three years of enforcement orders, which included both fines as well as a threat in 2018 to shut down coke batteries at U.S. Steel’s Clairton Coke Works if the company did not improve pollution controls. “Ultimately it remains to be seen, because we can levy tariffs, and we can take people to court, and we can get promises. But if those promises aren’t kept, it comes down to, is the industry going to do what it needs to do?”

Matt Mehalik, executive director at the Pittsburgh-based environmental group Breathe Project, commended the health department for becoming more aggressive with enforcement policies and for working with organizations like the Breathe Project to incorporate their expertise and support.

Even as air quality issues improve, Mehalik cautioned against becoming complacent, pointing out that several studies still rank the Pittsburgh region’s air quality among the worst in the nation.

“It’s important for people to stay focused on that, and that our air pollution is coming from local industrial sources,” Mehalik said.

Conversations around air quality intensified this year after a Dec. 24 fire at the Clairton Coke Works knocked pollution controls offline for months. Following the fire, activists and residents criticized health department officials for waiting two and a half weeks to issue an alert about the potential for elevated air pollution that could have put vulnerable residents, like children, the elderly and those with existing health issues, at risk.

The Allegheny County Board of Health launched a nine-member search committee for a new director in June and expects to select a candidate within six months.

Ronald A. Sugar, deputy director of administration, will serve as interim director.

Sugar has worked for the health department since 2014 and is responsible for daily operations.

Details about how much the new director will be paid and how the salary will be funded are not yet available, county spokesperson Amie Downs said.

Hacker made $195,000 when she joined the department in 2013. The Heinz Endowments contributed $50,000 annually over the first four years of her tenure.

Hacker’s current salary — $226,225 — is now completely funded by the county.

Her last day with the health department will be July 31.