People
Why mayors should care about public health
A countdown clock sits on Hartford Mayor Arunan Arulampalam’s desk in City Hall, showing the number of days left in his term (1,150 on the day Harvard Public Health visits). It’s a memento from a Harvard Business School program for new mayors he’s participating in. Arulampalam jokes that he had a harder time in the program than the other new mayors because Hartford was the case study on a failure to collaborate. The events of the case happened 25 years ago, but “I’m still getting shit for it” from the other mayors, he says.
One of Arulampalam’s very first acts after taking office January 1, 2024 was creating an Office of Community Violence Intervention to coordinate between the city and several hospital-based programs. Arulampalam has made several moves to boost other social determinants of health, something he thinks mayors are uniquely positioned to do. And he aims to get the city its first supermarket, a goal that has eluded previous administrations.
The 39-year-old, who was born in Zimbabwe to Sri Lankan refugees and moved to the United States before he was two, graduated from Emory University and then law school at Quinnipiac University. Before running for office, he was CEO of the Hartford Land Bank, which works to reduce blight in the city. He talked with Michael F. Fitzgerald, the editor in chief of Harvard Public Health, about why mayors should care about public health even though it rarely leads to press conferences about achievements. The interview has been condensed and edited.
Harvard Public Health: I met you in the context of my reporting on the North Hartford Triple Aim Collaborative, which is trying to broadly address social drivers of health. You talked about housing, gun violence, recreation, and education—four big social drivers. They’re all valid issues on their own. What’s different about putting them in a health context?
Arulampalam: I have an inch-deep knowledge in public health—[in college] I did a minor in public health. What was amazing to me is that the biggest gains we made in public health—poverty eradication, nutrition, major diseases—most individuals didn’t recognize there were lives that were saved; people didn’t connect [those gains] to the public health interventions that were made.
To have a [public health] mindset you’ve got to be comfortable with doing the non-sexy stuff, doing the things that will actually move the needle for communities and not worrying about the credit that you get from it. One of the things that’s difficult in politics broadly and for mayors specifically is, to be successful, you’ve got to articulate visions. You’ve got to make gains in those visions. And then help the public connect the dots between the gains and the promises.
Sign up for Harvard Public Health
Delivered to your inbox weekly.
HPH: Are there places in Hartford that made especially noteworthy gains?
Arulampalam: North Hartford is a really good example. Depending on where you live in North Hartford, your life expectancy could be 16 years lower than the life expectancy of someone in West Hartford, just over a mile down the road. The vast majority of causality for that are the social determinants of health. Take access to food. The clear win for this administration would be to get a grocery store in the north end of Hartford. And we are working on that. We have an $8.5 million RFP [request for proposal] out right now.
We’re looking at turning some of our vacant lots into urban farms, working with a cohort of urban farmers who came out of the Keney Park Sustainability Project. I went and door-knocked with them and talked to the residents in that neighborhood, to make sure the residents understood what they were doing. They would ask things like, you know, for folks who are from Puerto Rico or one of the West Indian countries, what are some foods that you had growing up that you don’t find here in Hartford? We do the research to figure out if they could grow here.
[Keney Park] worked with every corner store and bodega in the neighborhood and said, “Hey, if we grow some lettuce, would you sell it? If we grew some kale, would you sell it?” Those sorts of small interventions don’t warrant a press conference. But they will have an actual impact on the social determinants that are [currently] leading to shorter lives for our residents.
HPH: If you’re trying to change life expectancy, you don’t see those numbers change really in one term.
Arulampalam: We’ve got to create an ecosystem, right? That requires a little bit of faith. If you do the right thing, even if you don’t get the credit for it up front, people will feel better about their city working.
Politicians try to understand public health through a politician’s lens: You weigh the political costs and the financial costs against the value it brings. You’re likely to underestimate the value of innovative solutions to public safety, violence prevention—to housing, certainly. And then we get into these crisis moments like the one we’re in now [with housing]. And then you tend to fight for shorter-term solutions that might deliver political results. But they don’t really move the needle for the communities you’re serving.
Residents, actually, are very astute, especially residents in the neighborhoods that feel this pain, when it comes to identifying whether proposed solutions are going to get them closer to where they want to go or whether they’re just, you know, fluff, a political trick. I don’t believe the residents are looking to see if the metrics change. I think they’re looking for a really viable plan that will eventually lead to a change in metrics.
HPH: I saw that there was a drop in murders and shootings in your first year. One of the very first things you did was create an Office of Violence Prevention. Can you point to this office to say it has helped with this?
A countdown clock for the number of days left in Mayor Arulampalam's term sits on his desk.
Michael F. Fizgerald
Arulampalam: I think the office is still a little new for that. Our metrics around public safety actually have really shifted. Our police department has gotten smarter in policing, in many ways, deploying the same kind of public health-based techniques that you would for addressing disease: targeting those who are most likely to commit acts of crime [and] monitoring and trying to interrupt gang activity before the summer hits when there’s usually a spike in crime. We moved 15 additional cops on patrol, so the response time to crime has shortened.
From the year before [I took office], murders are down 55 percent; shootings are down 28 percent. That’s what grabbed the headlines. To me, the most telling statistic is that group and gang violence was 1.6 percent of shootings. That tells me that there wasn’t continual retaliation between gangs. The hospital-based violence intervention programs, which are coordinated by this new office of ours, [are] really working [so] that as soon as somebody got to the hospital with a gunshot wound, every service that we could give them as a city was provided at their fingertips. We opened up night gyms this summer, a thousand kids in night gyms. That was incredibly successful in giving kids a safe place to be.
HPH: I’m curious about the dynamic that you think mayors and public health directors should have.
Arulampalam: Our public health department is very focused on things like infectious disease and chronic disease. [Ebony Shaheed-Jackson, its director] has done great work. She has created this mobile health clinic, got funding for it. But things like developing housing, ensuring that that housing is up to code, the impact of education systems, don’t neatly fit into [public health] goals. And yet all of those components have to work together in order to create healthier communities. The greatest authority and power mayors can have in many places is the power of the convener. If you reach out to the heads of your major [institutions] and ask them to come to your table, they will do that.
HPH: Where do the tradeoffs come when you’re trying to [make] public health decisions?
Arulampalam: We’re a city of less than 19 square miles, half of which is untaxable. We’ve got about 120,000 people, but we’re the center of a metro area of 1.2 million people. We’ve got 93 percent of the homeless shelter beds for that larger region. We’ve got all the methadone clinics. And that means the city is consistently under-resourced for the size and scope of challenges that we are addressing. If you go into our homeless shelters, it’ll be a small minority of people in those shelters who are from Hartford. The case that I’m trying to make to my surrounding mayors is that if we don’t work together, it’s not just to the detriment of the city of Hartford, it’s a detriment to the entire region.
HPH: Let’s just say that you’re going to run for reelection. What would you like to be able to say about the public’s health?
Arulampalam: My hope is that we have made actionable and sustainable gains in public safety. That there is a vastly improved infrastructure of access to healthy foods in the city. And that all of the partners in that health effort from the large hospitals to the community health clinics to the on-the-ground efforts are all in alignment. I hope we’ll be working off [of] a consistent set of data towards a consistent set of goals. I don’t know if that’ll all come together in 1,150 days. But my hope is that we’ve made progress on that.
Top photo: City of Hartford
Republish this article
<p>“To have a public health mindset, you’ve got to be comfortable doing the non-sexy stuff,” says Arunan Arulampalam.</p>
<p>Written by Michael F. Fitzgerald</p>
<p>This <a rel="canonical" href="https://harvardpublichealth.org/policy-practice/qa-with-hartford-mayor-arunan-arulampalam-on-public-health/">article</a> originally appeared in <a href="https://harvardpublichealth.org/">Harvard Public Health magazine</a>. Subscribe to their <a href="https://harvardpublichealth.org/subscribe/">newsletter</a>.</p>
<p class="has-drop-cap">A countdown clock sits on Hartford Mayor Arunan Arulampalam’s desk in City Hall, showing the number of days left in his term (1,150 on the day <em>Harvard Public Health</em> visits). It’s a memento from a Harvard Business School program for new mayors he’s participating in. Arulampalam jokes that he had a harder time in the program than the other new mayors because Hartford was the case study on a failure to collaborate. The events of the case happened 25 years ago, but “I’m still getting shit for it” from the other mayors, he says.</p>
<p>One of Arulampalam’s very first acts after taking office January 1, 2024 was creating an Office of Community Violence Intervention to coordinate between the city and several hospital-based programs. Arulampalam has made several moves to boost other social determinants of health, something he thinks mayors are uniquely positioned to do. And he aims to get the city its first supermarket, a goal that has eluded previous administrations.</p>
<p>The 39-year-old, who was born in Zimbabwe to Sri Lankan refugees and moved to the United States before he was two, graduated from Emory University and then law school at Quinnipiac University. Before running for office, he was CEO of the Hartford Land Bank, which works to reduce blight in the city. He talked with Michael F. Fitzgerald, the editor in chief of <em>Harvard Public Health</em>, about why mayors should care about public health even though it rarely leads to press conferences about achievements. The interview has been condensed and edited.</p>
<p><strong>Harvard Public Health:</strong> I met you in the context of my reporting on the <a href="https://unitedwayinc.org/our-work/life-expectancy/nhtac/" target="_blank" rel="noreferrer noopener">North Hartford Triple Aim Collaborative</a>, which is trying to broadly address social drivers of health. You talked about housing, gun violence, recreation, and education—four big social drivers. They're all valid issues on their own. What's different about putting them in a health context?</p>
<p><strong>Arulampalam: </strong>I have an inch-deep knowledge in public health—[in college] I did a minor in public health. What was amazing to me is that the biggest gains we made in public health—poverty eradication, nutrition, major diseases—most individuals didn’t recognize there were lives that were saved; people didn't connect [those gains] to the public health interventions that were made.</p>
<p>To have a [public health] mindset you've got to be comfortable with doing the non-sexy stuff, doing the things that will actually move the needle for communities and not worrying about the credit that you get from it. One of the things that's difficult in politics broadly and for mayors specifically is, to be successful, you've got to articulate visions. You've got to make gains in those visions. And then help the public connect the dots between the gains and the promises.</p>
<p><strong>HPH:</strong> Are there places in Hartford that made especially noteworthy gains?</p>
<p><strong>Arulampalam:</strong> North Hartford is a really good example. Depending on where you live in North Hartford, your life expectancy could be 16 years lower than the life expectancy of someone in West Hartford, just over a mile down the road. The vast majority of causality for that are the social determinants of health. Take access to food. The clear win for this administration would be to get a grocery store in the north end of Hartford. And we are working on that. We have an $8.5 million RFP [request for proposal] out right now.</p>
<p>We're looking at turning some of our vacant lots into urban farms, working with a cohort of urban farmers who came out of the <a href="https://keneyparksustainability.org/" target="_blank" rel="noreferrer noopener">Keney Park Sustainability Project</a>. I went and door-knocked with them and talked to the residents in that neighborhood, to make sure the residents understood what they were doing. They would ask things like, you know, for folks who are from Puerto Rico or one of the West Indian countries, what are some foods that you had growing up that you don't find here in Hartford? We do the research to figure out if they could grow here.</p>
<p>[Keney Park] worked with every corner store and bodega in the neighborhood and said, “Hey, if we grow some lettuce, would you sell it? If we grew some kale, would you sell it?” Those sorts of small interventions don’t warrant a press conference. But they will have an actual impact on the social determinants that are [currently] leading to shorter lives for our residents.</p>
<p><strong>HPH: </strong>If you're trying to change life expectancy, you don't see those numbers change really in one term.</p>
<p><strong>Arulampalam:</strong> We've got to create an ecosystem, right? That requires a little bit of faith. If you do the right thing, even if you don't get the credit for it up front, people will feel better about their city working.</p>
<p>Politicians try to understand public health through a politician's lens: You weigh the political costs and the financial costs against the value it brings. You're likely to underestimate the value of innovative solutions to public safety, violence prevention—to housing, certainly. And then we get into these crisis moments like the one we're in now [with housing]. And then you tend to fight for shorter-term solutions that might deliver political results. But they don't really move the needle for the communities you're serving.</p>
<p>Residents, actually, are very astute, especially residents in the neighborhoods that feel this pain, when it comes to identifying whether proposed solutions are going to get them closer to where they want to go or whether they're just, you know, fluff, a political trick. I don't believe the residents are looking to see if the metrics change. I think they're looking for a really viable plan that will eventually lead to a change in metrics.</p>
<p><strong>HPH: </strong>I saw that there was a drop in murders and shootings in your first year. One of the very first things you did was create an Office of Violence Prevention. Can you point to this office to say it has helped with this?</p>
<p><strong>Arulampalam: </strong>I think the office is still a little new for that. Our metrics around public safety actually have really shifted. Our police department has gotten smarter in policing, in many ways, deploying the same kind of public health-based techniques that you would for addressing disease: targeting those who are most likely to commit acts of crime [and] monitoring and trying to interrupt gang activity before the summer hits when there's usually a spike in crime. We moved 15 additional cops on patrol, so the response time to crime has shortened.</p>
<p>From the year before [I took office], murders are down 55 percent; shootings are down 28 percent. That's what grabbed the headlines. To me, the most telling statistic is that group and gang violence was 1.6 percent of shootings. That tells me that there wasn't continual retaliation between gangs. The hospital-based violence intervention programs, which are coordinated by this new office of ours, [are] really working [so] that as soon as somebody got to the hospital with a gunshot wound, every service that we could give them as a city was provided at their fingertips. We opened up night gyms this summer, a thousand kids in night gyms. That was incredibly successful in giving kids a safe place to be.</p>
<p><strong>HPH: </strong>I'm curious about the dynamic that you think mayors and public health directors should have.</p>
<p><strong>Arulampalam: </strong>Our public health department is very focused on things like infectious disease and chronic disease. [Ebony Shaheed-Jackson, its director] has done great work. She has created this mobile health clinic, got funding for it. But things like developing housing, ensuring that that housing is up to code, the impact of education systems, don’t neatly fit into [public health] goals. And yet all of those components have to work together in order to create healthier communities. The greatest authority and power mayors can have in many places is the power of the convener. If you reach out to the heads of your major [institutions] and ask them to come to your table, they will do that.</p>
<p><strong>HPH: </strong>Where do the tradeoffs come when you're trying to [make] public health decisions?</p>
<p><strong>Arulampalam: </strong>We're a city of less than 19 square miles, half of which is untaxable. We've got about 120,000 people, but we're the center of a metro area of 1.2 million people. We've got 93 percent of the homeless shelter beds for that larger region. We've got all the methadone clinics. And that means the city is consistently under-resourced for the size and scope of challenges that we are addressing. If you go into our homeless shelters, it'll be a small minority of people in those shelters who are from Hartford. The case that I'm trying to make to my surrounding mayors is that if we don't work together, it's not just to the detriment of the city of Hartford, it's a detriment to the entire region.</p>
<p><strong>HPH: </strong>Let's just say that you’re going to run for reelection. What would you like to be able to say about the public's health?</p>
<p class=" t-has-endmark t-has-endmark"><strong>Arulampalam: </strong>My hope is that we have made actionable and sustainable gains in public safety. That there is a vastly improved infrastructure of access to healthy foods in the city. And that all of the partners in that health effort from the large hospitals to the community health clinics to the on-the-ground efforts are all in alignment. I hope we’ll be working off [of] a consistent set of data towards a consistent set of goals. I don't know if that'll all come together in 1,150 days. But my hope is that we’ve made progress on that.</p>
<p class="is-style-t-caption">Top photo: City of Hartford</p>
<p></p>
<script async src="https://www.googletagmanager.com/gtag/js?id=G-S1L5BS4DJN"></script>
<script>
window.dataLayer = window.dataLayer || [];
if (typeof gtag !== "function") {function gtag(){dataLayer.push(arguments);}}
gtag('js', new Date());
gtag('config', 'G-S1L5BS4DJN');
</script>
Republishing guidelines
We’re happy to know you’re interested in republishing one of our stories. Please follow the guidelines below, adapted from other sites, primarily ProPublica’s Steal Our Stories guidelines (we didn’t steal all of its republishing guidelines, but we stole a lot of them). We also borrowed from Undark and KFF Health News.
Timeframe: Most stories and opinion pieces on our site can be republished within 90 days of posting. An article is available for republishing if our “Republish” button appears next to the story. We follow the Creative Commons noncommercial no-derivatives license.
When republishing a Harvard Public Health story, please follow these rules and use the required acknowledgments:
- Do not edit our stories, except to reflect changes in time (for instance, “last week” may replace “yesterday”), make style updates (we use serial commas; you may choose not to), and location (we spell out state names; you may choose not to).
- Include the author’s byline.
- Include text at the top of the story that says, “This article was originally published by Harvard Public Health. You must link the words “Harvard Public Health” to the story’s original/canonical URL.
- You must preserve the links in our stories, including our newsletter sign-up language and link.
- You must use our analytics tag: a single pixel and a snippet of HTML code that allows us to monitor our story’s traffic on your site. If you utilize our “Republish” link, the code will be automatically appended at the end of the article. It occupies minimal space and will be enclosed within a standard <script> tag.
- You must set the canonical link to the original Harvard Public Health URL or otherwise ensure that canonical tags are properly implemented to indicate that HPH is the original source of the content. For more information about canonical metadata, click here.
Packaging: Feel free to use our headline and deck or to craft your own headlines, subheads, and other material.
Art: You may republish editorial cartoons and photographs on stories with the “Republish” button. For illustrations or articles without the “Republish” button, please reach out to republishing@hsph.harvard.edu.
Exceptions: Stories that do not include a Republish button are either exclusive to us or governed by another collaborative agreement. Please reach out directly to the author, photographer, illustrator, or other named contributor for permission to reprint work that does not include our Republish button. Please do the same for stories published more than 90 days previously. If you have any questions, contact us at republishing@hsph.harvard.edu.
Translations: If you would like to translate our story into another language, please contact us first at republishing@hsph.harvard.edu.
Ads: It’s okay to put our stories on pages with ads, but not ads specifically sold against our stories. You can’t state or imply that donations to your organization support Harvard Public Health.
Responsibilities and restrictions: You have no rights to sell, license, syndicate, or otherwise represent yourself as the authorized owner of our material to any third parties. This means that you cannot actively publish or submit our work for syndication to third-party platforms or apps like Apple News or Google News. Harvard Public Health recognizes that publishers cannot fully control when certain third parties aggregate or crawl content from publishers’ own sites.
You may not republish our material wholesale or automatically; you need to select stories to be republished individually.
You may not use our work to populate a website designed to improve rankings on search engines or solely to gain revenue from network-based advertisements.
Any website on which our stories appear must include a prominent and effective way to contact the editorial team at the publication.
Social media: If your publication shares republished stories on social media, we welcome a tag. We are @PublicHealthMag on X, Threads, and Instagram, and Harvard Public Health magazine on Facebook and LinkedIn.
Questions: If you have other questions, email us at republishing@hsph.harvard.edu.
More in Policy & Practice
A National Weather Service for disease?
To break cycles of trauma, we need family-friendly addiction treatment
