Tackling substance abuse is no small task, but the Cabell-Huntington Board of Health is making great strides.
As we read in the news and see around us every day, West Virginia has serious health challenges—diabetes and obesity, smoking, and opioid addiction among them. Helping those who are suffering takes the hands-on, day-to-day work of thousands of dedicated health care practitioners across the state.
But improving the health of West Virginians as a whole requires systemic change. That’s why, this year, we’re honoring six West Virginia health care professionals. As leaders of the largest industry in the state, they are fundamentally changing the ways we think about, practice, and pay for health care. They are our 2023 Changemakers of Care.
As the CEO and health officer at the Cabell-Huntington Board of Health, Dr. Michael Kilkenny has a lot to juggle. The Ohio native arrived at Marshall in 1971 and made Cabell County his home.
“I liked that the campus was small and manageable, with very friendly people,” he says. “It was easy to find my place in Appalachia, as opposed to the Midwest. That Midwestern culture doesn’t speak to me the way the Appalachian culture does.”
In his years as an Appalachian by choice, Kilkenny has worked in several West Virginia counties, including Lincoln, Monroe, Summers, and Wayne. He enjoyed seeing patients one-on-one, getting to know their families, and helping them solve their individual problems, but he was always interested in larger groups of people. Moving toward public health was a start.
“How do you help a county? How do you help a state?” he asks. “Now that I serve on the National Association of County and City Health Officials, we’ve had a remarkable impact, even at a national level. We’ve done things we never even dreamed would be possible or successful.”
One of the most noteworthy of these has been the focus on substance abuse in Cabell County. It’s important, Kilkenny says, to learn from the successes and failures of other cities and pass those lessons on, which is what he and his colleagues have done.
“Huntington led the state in overdose deaths,” he says. “There’s still a problem, but now we’re not leading. And we saw a major outbreak of HIV controlled very rapidly because we had tools, processes, and partnerships in place.” When Kilkenny saw how the health department’s measures helped in Huntington and Cabell County, he felt an obligation to share these experiences with other communities that were struggling to address the same problems. “Getting the opportunity to share what was helpful is some of the most gratifying work I’ve been able to do in my career.”
In a community and state struggling with addiction, the tasks at hand can feel overwhelming, but Kilkenny and his team like to view challenges as opportunities. He cites the stigma associated with HIV and injection drug use as an example. Intervention programs like Huntington’s work with a stigmatized population suffering from stigmatized diseases. The stigma, he says, is just as much an obstacle as addiction and drug abuse are.
“Stigma is a tremendous challenge to success,” he says. “If you see something as unsolvable, something that you just want to disappear, that’s magical thinking that doesn’t get you where you want to go. So I put that out of my mind and look at what we can do, not what we can’t.”
One key, he says, is collaboration. “The biggest success for Cabell County and Huntington is that all of our agencies work together to solve the problem. This is partnership. This is Appalachian culture. Neighbors and communities pull together at a time of crisis and work to solve that. Huntington does that. If you don’t, you’re not going to get the same success. We found here that if you do something and you do it small, you’re going to get small success. If you want big success, you’ve got to do it big.”
Kilkenny believes trust and understanding are core to public health. The department applies a stringent set of rules to every decision and tries to make conservative recommendations, especially when it comes to spending taxpayer dollars and helping the taxpayer. “That’s a lot of responsibility,” he says. “Those of us in public health take that very seriously, and we want people to know that.”
Just as West Virginia’s challenges continue, so do Kilkenny and his colleagues, and he’s grateful for the opportunity to help his community. “It’s just a lot of fun to work and serve the people. We’re going to continue to do the very best we can with what we’ve got.”