A few weeks after Dr. Iulia Vann became the new director of the Allegheny County Health Department, a clean air advocate slipped her a written invitation to meet with his group in Clairton. Her answer was yes. She traveled last month to the Mon Valley town — home to the nation’s largest coking factory — to hear the community’s pleas for better air quality.
Vann, who moved to the region from North Carolina, was just shy of completing her first 100 days in the role when she arrived at the Clairton Municipal Building. She took notes and nodded frequently as Valley Clean Air Now [VCAN] board members voiced their frustrations over what they said was the county’s anemic approach to regulating industrial polluters including U.S. Steel. The firm owns Clairton Coke Works — the county’s most toxic air polluter, according to a 2021 report by PennEnvironment. Residents have long blamed the facility for the area’s high rates of cancer and lung disease, among other chronic ailments.
“You have a big job ahead of you,” Dave Meckel, a VCAN board member, told Vann.
Meckel and his wife, Cindy, live in nearby Glassport, just north of the coke works. He told Vann his house is covered in fine particulate matter. The Environmental Integrity Project — a nonprofit focused on curbing industrial pollution — set up a monitor on their property in 2021, and found high concentrations of benzene, a known carcinogen.
“It’s really humbling to be in this room with you,” Vann told Meckel and the other board members, all of whom are Mon Valley residents. The experiences they shared are “really, really concerning,” she added.
It was an opportunity the advocates said they’d never had until that day: an audience with the county’s top public health official, a newcomer they hoped would change the culture at the Health Department, which they felt had failed to protect them and their families. They offered Vann advice on how the department might better regulate polluters, and how it could be more transparent with the public. Cindy Meckel told a reporter afterward that Vann “actively listened,” which gave her fresh hope.
Later that day, Vann sat down for an interview with PublicSource and WESA in the Health Department building Downtown. She discussed her background as a medical doctor in her native Romania, her achievements as a public health official in Guilford County, North Carolina, and her plans to take on the county’s most pressing public health problems.
Leaving medicine to make ‘a bigger impact’
Vann was working as a family doctor in Bucharest, Romania, when she wondered if practicing medicine was right for her. She was alarmed by how young some of her patients with diabetes, hypertension and heart disease were.
She recounted thinking, “I shouldn’t be sitting here all day, every day, seeing these chronic diseases progress the way that they’re progressing,” explaining she wanted “to have a bigger impact” that would affect entire communities.
She moved to the United States, earned a master’s degree in public health from East Carolina University and got her feet wet in county government roles across North Carolina. She spent the past five years in Guilford County, home to Greensboro and with roughly half of Allegheny County’s population. She rose to the top job at its health department on March 3, 2020.
About a week later, the World Health Organization declared COVID-19 a pandemic — a development that local media called a “baptism by fire” for Vann.
She said she worked up to 120 hours per week with her team and rarely saw her family, including her two children. She almost never spoke with reporters before the pandemic but, like many public health officials, started doing regular press conferences to reach as many people as possible. And she convinced hospital and pharmacy officials to share data about vaccine availability, which helped the county direct supplies where they were most needed, according to Merle Green, executive director of the Association of North Carolina Boards of Health and Vann’s predecessor at the Guilford County Public Health Department. She made the process “legal and seamless,” Green wrote in response to an inquiry from PublicSource and WESA.
Vann said she experienced “trauma and burnout” during those years, but the experience made her a better public health official. She learned to prioritize public outreach and partnerships in the community — a philosophy she’s brought to her current role. “We can never do things in public health on our own,” she added.
Why the county chose Vann
Vann’s appointment ended an 18-month leadership vacuum at the Health Department, which is responsible for:
The previous director was Dr. Debra Bogen, a pediatrician who started in that role just as Vann took over in Guilford County. Bogen was tapped in January 2023 by Gov. Josh Shapiro to be Pennsylvania’s secretary of health. Patrick Dowd, the department’s former chief operating officer who has a doctorate in history, served as interim director until July. Dr. Barbara Nightingale, a psychiatrist and family doctor who oversees the department’s clinical services, took over the role until Vann’s arrival in August.
“She will have to make sure the Health Department can still protect people’s health, given that we’re likely to see the rollback of all kinds of federal environmental and health regulations.”
The county took more than six months to fill the post — an effort led by the Board of Health and County Executive Sara Innamorato’s office. The search committee narrowed the candidate pool to 12 finalists, including Vann. Her “people skills” made her stand out, said Dr. Lee Harrison, a committee member and the board’s chair.
“You’ve got to interact effectively with [the] Board of Health, you’ve got to interact effectively with the county executive and her team, and then you’ve got this big staff you’ve got to manage as well,” he said, referring to the department’s more than 400 employees.
Fresh hope for advocates
Soon after Innamorato was elected last year, a coalition of 33 organizations and 38 individuals called for a new Health Department director with specific skills and qualities. Under the banner of the Equitable and Just Greater Pittsburgh Network [EJGP], the group urged Innamorato and the board in a letter to find someone who would take on social determinants of health and health disparities, often driven by racism, unequal access to jobs and health care, and the county’s built environment. That person should be open, transparent and skilled at reaching historically overlooked communities, the group wrote.
After Vann was unanimously approved by the board in June, some members of the network told PublicSource they had wanted a much more public selection process. But they said they were impressed by Vann, who they said embodies many of the qualities they called for in the letter.
Her willingness to meet with advocates in their own neighborhoods “is a good indication of how she sees her work,” said EJGP Director Jason Beery, who spoke with Vann during a virtual panel with the network’s members in October.
“Those folks haven’t [always] had a real advocate … in the Health Department director,” he added, expressing hope that Vann would “be a voice for them within the Health Department, within county government and across the county.”
After meeting with Vann in Clairton, four VCAN board members told a reporter they were eager to see what she will accomplish and hoped she’d turn the page for the community’s relationship with the Health Department.
“I noticed that she was taking notes, so apparently she felt that [our feedback] was something she needed to remember,” said Johnie Perryman, the group’s vice president and a Clairton resident whose health declined after a 2018 fire took out the pollution control system at the coke works. He noted that Vann said she’d read the 35-page brief the group sent her ahead of time and referred to it while asking questions.
Asked if she’ll keep taking such meetings beyond her first year, Vann said, “Absolutely.
“This is the core of who we are and who we should be [as public health officials]. And I am not one to just sit behind a desk and … be on my computer all day,” she added.
New leadership, longstanding problems
Vann is inheriting the county’s most intractable public health problems, such as unhealthy housing, the opioid overdose epidemic and racial and geographic disparities in health outcomes.
The county has a high Black maternal mortality rate: Black birthers here are two and a half times more likely to experience maternal death than their white counterparts, according to Health Department data. The department’s infant mortality report found that Black infants were almost four times more likely to die before their first birthday than white infants between 2015 and 2019.
Vann took on similar disparities in Guilford County. Under her leadership, that county formed North Carolina’s only fetal and infant mortality review program. Such programs examine fetal and infant deaths and exist in just 27 states, including Pennsylvania. Vann also pushed for a “community action plan” that included improving access to doulas, providing support for breastfeeding and educating new moms about the importance of postpartum follow-up care. North Carolina Health News reported in April that county officials “continue to struggle with high death rates,” so it’s unclear how successful the effort has been.
In Clairton, Vann was forthright about having less experience with air quality issues and regulating industrial polluters, who regularly pay fines that some say do little to deter violations.
“I come from a community [where] air quality was not a problem,” she told the group.
And advocates said anyone in her role will be limited by bureaucracy in county government.
“Realistically, I think she can achieve some policy changes,” said Allegheny County Councilor Michelle Naccarati-Chapkis, who’s also the executive director of Women for a Healthy Environment. She pointed to updates to the housing code and working with a new Housing Advisory Committee — slated to become active Jan. 1 — as areas where Vann could make a real difference.
‘An exciting new era’ for public health
Harrison, the Board of Health chair, said Vann’s arrival has started a new chapter for public health in Allegheny County. She’ll soon be working with eight new board members, who were appointed last month by Innamorato and must be approved by County Council.
“It’s an exciting new era with basically almost an entirely new board, a new director, a new county executive who’s very committed to public health,” said Harrison, who plans to step down once the new board is installed.
But there are challenges ahead, too. All local public health officials are facing an incoming presidential administration that could be hostile to evidence-based public health policy.
“Maybe that’s the biggest thing that she’s going to have to address and figure out over the next year,” said Beery of the EJGP network. She will have to make sure the Health Department can “still protect people’s health, given that we’re likely to see the rollback of all kinds of [federal] environmental and health regulations.”
Asked about these headwinds, Vann said “public health is resilient. We find ways to do and get our work done.”
Venuri Siriwardane is PublicSource’s health and mental health reporter. She can be reached at venuri@publicsource.org or on Bluesky @venuri.bsky.social.
Kiley Koscinski is WESA’s health and science reporter. She can be reached at kkoscinski@wesa.fm.
This story was fact-checked by Elizabeth Szeto.
This reporting has been made possible through the Staunton Farm Mental Health Reporting Fellowship and the Jewish Healthcare Foundation.