Meet a Changemaker: Dr. Naveena Bobba, San Francisco Department of Public Health
For this installment of our “Meet a Changemaker” series, we celebrate the work of Dr. Naveena Bobba and the San Francisco Department of Public Health as they continue their efforts to vaccinate residents against COVID-19.
The Department of Public Health has worked with community members and partners to carefully consider vaccine delivery, especially to vulnerable populations, and offer incentives to get vaccinated — from pre-loaded Clipper Cards to tickets to the zoo and museums in San Francisco. Read on to learn more about how Dr. Bobba and her Department deliver vaccinations with equity, collaboration, and community feedback.
Follow the San Francisco Department of Public Health at @SF_DPH.
Can you please describe your work at the San Francisco Department of Public Health?
Sure — I am a physician by training and the Deputy Director for the San Francisco Department of Public Health (DPH). My role with the Department is to oversee its policy and planning. DPH is a large department with both a healthcare function — as San Francisco’s primary safety net provider — and a public health function. A lot of my work is coordinating and advancing the Department’s strategic priorities.
DPH has obviously played a big role in responding to COVID-19. How has your role evolved, both at an individual and departmental level, during the pandemic response?
Like a lot of us in City government, there were a variety of things we were all working on prior to the pandemic. As a large healthcare delivery system, the Department focuses on providing healthcare to all the patients in our network, meeting our outcome goals, and ensuring that the outcomes for our patients are equitable across the board.
On the population health side, there is a lot of work done around our core functions for public health. This includes the Getting to Zero campaign to reduce HIV transmission and HIV-related deaths, climate change, equitable access to food and to safe streets — all efforts to ensure that the health of San Franciscans continues to improve over time.
When COVID-19 hit, it was absolutely critical to collaborate with City agencies, our academic partners, our community partners, and other healthcare systems to get us through this pandemic.
Because you’re dealing with a new disease, you don’t have a lot of information, and if everybody is going in a different direction, you wouldn’t necessarily get the best outcomes from a health perspective. So collaboration was key to working through all the unknowns and tackling the problems together — with the best science and data that we have as a city — and really focusing all of our systems towards that one goal of preventing COVID-19 spread.
As vaccines are made more readily available, your Department has been offering incentives to San Franciscans to get vaccinated. What are some of these incentives?
Vaccines had an arc where initially there was more demand than supply. So early in the vaccine rollout, our vaccine sites saw high volume. As vaccines became more readily available, we noted that vaccine uptakes started to peter off a bit. Part of our response was to understand the reasons why certain groups of people weren’t open or weren’t willing to get vaccinated at that point in time. And one of the things we heard was that making vaccination a family activity would go a long way in lowering the barrier to getting vaccinated.
So we worked to create events where entire families could come out and get vaccinated while also enjoying entertainment, snacks, and raffle tickets for prizes like free tickets to Skystar Wheel or SF Zoo, pre-loaded Clipper cards, and memberships to SFMOMA. This was all in the effort to help people see the benefits of getting vaccinated and have that extra little incentive to come out and get their shot.
The second wave of this incentive effort — which has been fantastic — is our partnership with the San Francisco Giants. The Giants have graciously provided vouchers to their games for those who received their dose. And we have seen an uptick in vaccinations because of that.
You dug into this a little bit in the previous question, but can you share more about how you and your Department conceptualize incentive ideas? What is the strategy that drives vaccine incentive efforts?
Absolutely. One of the things that came out of the pandemic is that we’ve strengthened the bonds with our community partners, which has helped us to really understand the needs of different communities and how best to serve them.
That means really understanding what the barriers and pain points are, especially for communities that have had a disproportionate impact from COVID-19 — Latino populations, Black populations, and Pacific Islander populations. Initially, we asked what were the barriers to COVID-19 testing and healthcare access, to ensure that residents got the wraparound services. And then when vaccines were available, what were the barriers to getting vaccinated?
One of the lessons learned is that unless you understand what the barriers are of a person day-to-day, you’re not going to be able to make a change in their lives. So simply putting up a post that says “vaccines available” isn’t always going to be the best way to get somebody vaccinated because there are so many other things that might prevent a person from being able to make that vaccination appointment — like having to work without time off or difficulty in arranging for childcare.
Collaboration and feedback loops with communities have been crucial to getting folks vaccinated. Our community partners are out there on the front lines along with City workers and our own DPH staff, and they get feedback on a regular basis — they talk to residents and try to understand what are the barriers to vaccination. We take that information in and see how we can problem solve around that to tailor initiatives that would help residents move forward towards vaccination. And that’s what leads to incentives like family events and making vaccines available in evenings and weekends.
What vaccination success have you seen?
Vaccine efforts in general have been very successful in San Francisco. At this point in time [July 2021], 74% of the entire San Francisco population has been vaccinated — which is really astounding.
I think the success we’ve seen with the vaccine roll-out is due to DPH’s laser focus on ensuring there was an equity lens from the start. When we rolled out the vaccine, we went to the neighborhoods that were hardest hit because we wanted to make sure they had first rate access to the vaccine. We also worked to meet the communities where they were. For example — and this has been documented in multiple studies — when people have questions about the vaccine, they want a doctor that they trust to be able to answer those questions. So we had some of our vaccine sites at medical offices that had appropriate language access and had physicians who are trusted and have cultural sensitivities in mind. And, at least anecdotally, we’re hearing people say “I saw Dr. X and it made a difference”.
And within populations that have not yet taken the vaccine, there have been reports that incentives — especially the Giants tickets and other sports incentives — have increased traffic towards vaccination. Again, this all points to the success you see when you collaborate with community partners to get feedback and shift strategies as communities’ needs change.
What does civic innovation mean to you? And how do you apply it to your work?
I think typically, we think of innovation within the context of the tech world. But what was interesting about this pandemic was how it demonstrated that innovation is also about partnering with others — community partners, academic partners — and utilizing all of our resources to solve a problem. And actually, a lot of the time, it was low tech.
Innovation is having conversations, really listening to each other, and coming to solutions together. It’s about taking a step back and asking who serves these communities most impacted by COVID-19; who are our partners in serving these communities; and how do we make sure that we continue to protect the health of these communities? Innovation is in collaboration and relationships.
Fun question! What’s your favorite landmark or area in San Francisco?
I love the Crissy Field, Presidio area. Part of the reason why I was able to stay sane last year was that I did a lot of running in this area, and it really does help. Nature is always a calming, wonderful experience.
About San Francisco Department of Public Health
The mission of the San Francisco Department of Public Health is to protect and promote the health of all San Franciscans. Learn more about the department here.