Pima County’s new Health Department Director has long been dedicated to helping others.
Theresa Cullen, M.D., MS assumed the director’s role at the Pima County Health Department on June 1. A glance past the chaotic circumstances under which she assumes this crucial post will reveal a career path from candy striper to Assistant U.S. Surgeon General to her current post. It seems linear, but perhaps not. It makes perfect sense, however, when Dr. Cullen describes the motivation behind her professional aspirations, achievements and her return to Tucson.'
Dr. Cullen was born in New York state, raised on a Pennsylvania farm, and relocated with her large Irish Catholic family to Phoenix in high school. The family was solidly middle class for most of her life until they lost everything and became dependent on welfare. One of the many strong tenets of her close family is the belief that every person should work to make the world a better place. Dr. Cullen took this to heart when, at 13 years old, she became a candy striper at the Phoenix Indian Medical Center in the pediatric ward. “I fell in love with the work and Native American cultures,” she explains.
After earning an undergraduate degree in philosophy and biology from Johnston College, Dr. Cullen returned to Arizona and worked on the Navajo reservation. One day, on a morning run, and just after attending a birth at the hospital, someone yelled to her that anybody who can get up at five in the morning to run can go to medical school. So, she applied and graduated from the University of Arizona College of Medicine in 1983. She began her career as a family practice physician for Indian Health Service (IHS) in Sells in 1984, and immediately after maternity leave for her third child, became the clinical director on the Tohono O’odham reservation. She later served as the senior medical informatics consultant, chief information officer, and director of the office of information technology for IHS.
Dr. Cullen concedes that going into administration wasn’t a planned career choice, but one made out of necessity to serve Arizona’s Native American community. “Indian health is such a resource-drained environment,” she reflects. “I believed that health technology could help with improved outcomes. The director and deputy told me that I could really have an impact on what we are doing. That’s how they got me.”
Dr. Cullen’s curriculum vitae includes a number of job titles that don’t easily roll off the tongue. She served as director of health and human services domain information technology program management office at the Department of Health and Human Services, as well as acting deputy director of the Department of Defense/ Department of Veterans Affairs Interagency Program Office. After retiring from the Commissioned Corps of the U.S. Public Health Service as a Rear Admiral, she served as the director of health informatics for Veterans Health Administration, and associate director of global health informatics and affiliate scientist for Regenstrief Institute.
Throughout her illustrious career, Dr. Cullen has earned an array of honors and awards. Among them is the Distinguished Service Medal, U.S. Public Health Service; three National Director’s Awards for Outstanding Achievements, Indian Health Service; Physician Leadership of the Year, Indian Health Service; Vernon and Virginia Furrow Award for Excellence in Clinical Sciences Teaching for Medical Students, University of Arizona College of Medicine; Meritorious Service Medal; Outstanding Service Medal; and Unit Citation Medal, U.S. Public Health Service.
Over the five years prior to joining Pima County, Dr. Cullen worked mostly internationally and was gone three to four weeks at a time. Her youngest daughter lives in Tucson and sent her the job posting with a request to apply so she could be around family more. “I had a great job,” Cullen recalls. “I thought, ‘think globally, act locally.’ I love Tucson. My husband has lived here since he was three. So, I applied thinking I could really make a difference. I have experience and perspective from working regionally, nationally, and internationally. What an amazing thing to meander back and do local work.”
Ensuring health equity is Dr. Cullen’s primary personal and professional objective. This means to ensure every individual has access to the services they need to achieve the best health status they can. True health equity goes beyond health care delivery and spans to housing, food security, food safety, and access to education. Dr. Cullen explains, “When I interviewed with Mr. Huckleberry, he mentioned that Pima County is committed to health equity. That clinched my coming here.”
The goal of the Pima County Health Department is to improve the health status of the population of the county in conjunction with municipalities and cities. It’s probably best known for consumer health and food safety. Yet, infectious disease tracking and mitigation, clinical services, family planning, mental health, and WIC (Women, Infants and Children) program coordination also fall within its umbrella of responsibility. In short, the department identifies the needs of individuals, addresses them in conjunction with the community, and evaluates the impact of programs and interventions that are developed. Programs are segmented as primary (prevention activities — stop smoking, prevent obesity, food safety, bike safety); secondary (treatment — healthcare, family planning, WIC/nutrition); and tertiary (prevention of complications — administration, statistics, and environmental health).
Still new to the director position, Dr. Cullen passionately believes Pima County Health Department has been very attentive to responding to the community. “There are programs here that are nationally recognized, the REACH [Racial and Ethnic Approaches to Community Health] program is a model for the rest of the country,” she says.
Dr. Cullen refers often to the work of the health department as a journey that leadership and boots on the ground take in tandem, with individuals first, and the collective population next. Although most programs take three to five years to be distinguishable as effective, she marvels at how Tucson has handled the COVID-19 pandemic. “Tucson really has it together. I’ve been deployed in emergency situations all over the world. The emergency management program at the county has been incredibly helpful and efficient,” she remarks. The health department is responsible for the identification of COVID cases through testing, case investigation and contact tracing, and development and communication of health and safety protocols. The department created a program of liaisons so there is a person to work with high-risk groups to implement protocols and monitor those groups for needs and recurrent testing. These liaisons use the opportunity of connecting with individuals to share information about other non-pandemic related county programs that may assist them as well.
She concedes that there is so much about the COVID-19 virus we have yet to understand, but she feels that Pima County is well prepared for a possible resurgence. Surge plans are in place at hospitals. Standard operating procedures and protocols in place and on queue are designed to be elastic — adjustable to circumstances — and can be ramped up or pulled back.
The primary messaging from Dr. Cullen and the department includes the importance of wearing a face mask, washing your hands, and social distancing. “This is a time for all of us to recognize that we have a personal responsibility to keep the community safe,” she sums up.