The Governor

When Ronnie Musgrove became governor of Mississippi in 2000, the federal Children’s Health Insurance Program (CHIP) had been in place for more than a year, yet fewer than 1,000 children were enrolled. The Democratic governor and his team expanded outreach through public schools and increased their marketing and communications efforts. Within a year, 60,000 children were added to CHIP. It’s both a commendable achievement and a handy instructional tool for Musgrove, who joined the Bloomberg School in November 2013 as a senior policy scholar.

Musgrove’s experience as governor, lieutenant governor and state senator made him a natural for the first policy scholar in the Department of Health Policy and Management (HPM), according to Ellen MacKenzie, PhD ’79, MSc ’75, Fred and Julie Soper Professor and chair of the Department. “He’s inspirational [and] so committed. He’s already beginning to open doors for us,” says MacKenzie.

Musgrove does public affairs communications consulting work and splits his time between Washington, D.C., and Jackson, Miss., spending an average of four days a month in Baltimore. He’s met with faculty, spoken to classes about policy issues, is advising HPM on specific policy initiatives and will be connecting faculty with policymakers and agency officials. In late March, he met with Johns Hopkins Public Health editor Brian W. Simpson to talk about how policymakers think, how to advance public health in a conservative era and how to maximize advocacy.

What’s the next step for faculty who have evidence that they think should drive policy change?

One, I’m getting the faculty to understand why an issue is front-and-center for policymakers, and then to understand the questions that a policymaker has, what drives his or her decision making, and what kind of solutions will actually give the answers they seek. And to me, that’s the area that most researchers don’t deal with. That’s what I wanted to make sure that they can see, how does the policymaker think?

Policymakers connect with real life stories. Research is made of numbers, cold data and information that do not have connections to real life and how policies can make a difference in people’s lives. Making that connection is an important goal of mine here at Hopkins.

In an era that seems to be dominated by distrust of government, how do you advance public health?

It goes back to what’s important. Education is important, and just because government doesn’t work as well as you would like it to, you don’t abandon educating our people. Likewise, now is not the time to abandon ensuring that our people are healthier, more productive and, in fact, are less costly because they are well.

It’s no secret that many in public health are progressive, left of center. What should they understand about those who are in power on the right?

All the officials that I’ve had an opportunity to work with want to see improvements in education, in job opportunities, in health care. So it’s important to understand there are different points of view. But that’s the thing about good research. It doesn’t matter what the point of view is, the research stands on its own. And it creates and states facts irrespective of philosophy.

Many in public health see the city or state level as proving grounds for programs that can be adopted by other states, and maybe nationally.

Having solutions that work is persuasive. When you see the bottom line reduced, when you see the quality increase, or you see access to quality health care increase, those things get your attention. If they do all three, they really get your attention.

Mississippi and a lot of Southern states have some of the nation’s most serious health issues like obesity and hypertension. What will it take to turn things around?

I’ve said enacting more policies from Johns Hopkins research would be one. (Laughs.) Access is a problem sometimes in the South. Lifestyle is a problem, and I think we have some uniqueness in terms of our diets, etc. So those are all variables and factors in improving quality of life. But those are things that are part of any policy initiative that need to be considered.

How does one make those kinds of big, population-level gains without being accused of being the “nanny state”?

Going back to the example about the children’s health insurance policy, all we did was change the implementation procedure, and then we had 60,000 more children with health care. We didn’t change the law, we just changed the implementation. And so those things are important in the way you carry out policies. Sometimes, they can be broad to cover and help more people, or sometimes they can be narrow and restrictive, and fewer people are helped. I think that’s a matter of leadership.

How do you advise researchers who want to not only generate evidence but also advocate for change based on it?

Make sure of the credibility of the data before you say anything. And, from everyone that I’ve talked to here, to a person, they all agree that that’s the most important. And then, you can look at the various policy issues that could be derived from the research. What would be solutions, as a result of the research? And then, I think most researchers advocate, in some shape, form or fashion, for solutions that come out of the research.

Any plans to return to elected office?

One of my law partners once said this about being in public office: You’re never cured, you’re just in remission. But no, I enjoy doing what I’m doing right now. It gives me an opportunity to focus on some policy issues like here at Johns Hopkins. To open a dialogue with researchers, academic people, and connect them with policymakers—it’s outstanding. It’s a great time in my life.