Claude A. Jacob, DrPH, MPH is the Health Director at the PHAB-accredited San Antonio Metropolitan Health District (Metro Health). He oversees more than 30 programs that serve the City of San Antonio and Bexar County, a jurisdiction of over 2 million residents. A public health architect, Dr. Jacob takes great satisfaction in the role he plays—locally, regionally, and nationally—in building healthier, more equitable, and more resilient public health systems and communities.

Dr. Jacob recently took some time to reflect on his 25-plus years of public health service. He spoke with us about his career path and the invaluable roles that accreditation, leadership and equity play in shaping his public health practice.

Dr. Jacob’s formative years were rooted in healthcare and service. His father was a physician who served in the US Air Force and his mother was an operating room nurse. He was a high school athlete who considered a career as a clinician but a back injury in college put him on a different path. The care Dr. Jacob received gave him insights into the healthcare system, sparking a deeper interest in broader organizational systems and community networks as a lifelong public servant.

While was he born in the U.S., Dr. Jacob spent a significant part of his childhood in his parents’ homeland–Haiti. The experience of being a first-generation Haitian-American has had a tremendous influence on Dr. Jacob’s personal and professional journey. He proudly celebrates his African and Caribbean heritage which have had a strong influence in shaping his career. He volunteered as a tutor in the Haitian community on Chicago’s northside and helped to establish a sister-city relationship between Cambridge, Massachusetts and Les Cayes, Haiti following Haiti’s catastrophic earthquake in 2010.

Dr. Jacob is a past president of the Black Caucus of Health Workers (BCHW) of the American Public Health Association (APHA) and a recipient of the Hildrus A. Poindexter Award for distinguished service in the field of public health. In addition, he has served as a member of the National Association of Health Services Executives which anchors the national network of African American healthcare executives.  He has used this and many other platforms to advocate for mentorship and career opportunities for Black health professionals and to champion the educational needs of disadvantaged students.

PHAB Accreditation: Promoting a Culture of Quality Improvement (QI), Innovation, and Transformation

Dr. Jacob is the current chair of the PHAB Board of Directors and serves on the board of directors for the American Public Health Association and the Texas Association of City and County Health Officials. Dr. Jacob is also a past president of the National Association of County and City Health Officials (NACCHO) and is an emeritus member of NACCHO’s past presidents’ council. Through these and other board activities, Dr. Jacob has contributed to local, regional and national efforts to enhance public health systems that center equity and a culture of quality improvement in policy and practice.

Metro Health is the second PHAB-accredited health department that Dr. Jacob has had the opportunity to lead. Prior to his arrival in San Antonio in 2021, Dr. Jacob directed the Cambridge Public Health Department for 14 years. Leading two PHAB-accredited entities has allowed him to experience firsthand the impact of accreditation and its QI processes. Dr. Jacob explained:

“Shaping a QI culture invites health departments–large and small–to become better at what they do internally, so their external work has more impact to influence health outcomes in the community.” He added: “We should demonstrate more swagger for the work that we do on the ground to be recognized as the health strategists of record for our jurisdictions served, nothing speaks to the caliber of our policies and innovative practices more than PHAB accreditation.”

Dr. Jacob shared how PHAB supports public health transformation. In Fall 2023, Metro Health achieved a major benchmark in its ongoing transformation with the rollout of its Metro Health 2.0 Strategic Plan, which was informed by PHAB’s guidelines and other national, evidence-based frameworks. Dr. Jacob calls Metro Health 2.0: “the lodestar for our efforts to create the infrastructure and QI culture required to respond to today’s complex public health challenges.”  This plan articulates the department’s multi-year commitment to fostering robust cross-sector collaborations, recruiting and retaining talented staff and volunteers and applying lessons learned from the COVID-19 pandemic to enhance its capabilities.

Leadership, Equity, and Systems Change

Centering equity in policies, practices, and partnerships has been a top priority for Metro Health and Dr. Jacob. In 2022, Dr. Jacob spearheaded the launch of San Antonio Forward (SA Forward), which is Metro Health’s multi-year plan to address the priority areas and social conditions that have been impacted by the COVID-19 pandemic. Under the aegis of SA Forward, Metro Health established the Office of Mental Health & Community Resilience as well as the Policy & Civic Engagement Office (PaCE) and made enhancements to its Office of Health Equity. The PaCE Office works with area partners to address inequities at the population level while the Office of Health Equity seeks to address staff training needs within the organization. “This two-pronged approach is a necessary step for engaging both our staff as well as community members to ensure the best chance at achieving optimal health and wellness.”

Dr. Jacob stated that the underlying philosophy for the department’s equity efforts is HEAL—History, Environment, Authenticity, and Learning. He said: “At the end of the day, it’s about engaging in safe, non-judgmental and generative spaces. Gaining more insights about our shared and interconnected histories is a necessary step for understanding the complex social, historical, economic, and political factors that contribute to the inequities and disparities that impact our communities to this very day. The COVID-19 pandemic magnified our vulnerabilities as a society and has forced us to revisit the ways that we address the social and structural drivers of poor health outcomes.”

Dr. Jacob stresses the need for a public health leadership and workforce that is diverse, culturally informed, and dedicated to equitable systems change as a call to action: “It’s been an honor to serve in a variety of communities over the years. Between Chicago, Baltimore, Cambridge (MA) and now San Antonio, I hope that my contributions to the public health landscape will inspire the next generation of health professionals. I encourage up-and-coming public health leaders to be authentic and committed to fighting for everyone’s right to optimal.”

“We should demonstrate more swagger for the work that we do on the ground to be recognized as the health strategists of record for our jurisdictions served, nothing speaks to the caliber of our policies and innovative practices more than PHAB accreditation.”

– Dr. Claude A. Jacob, SAMHD

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