The City of San Antonio fired Metropolitan Health District Director Dr. Thomas Schlenker last Wednesday for what City officials called a “personnel matter.” City Manager Sheryl Sculley cited three supposedly offensive comments made to co-workers over the last two years as cause, Dr. Schlenker said Monday.
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He said the true, unofficial reason for his dismissal was his strong stance against the influence of soft drink companies on public health policies. Dr. Schlenker led Metro Health’s attempt to organize an anti-sugary drink campaign that failed late last year, a failure he attributes to the City’s insistence that the soda industry be included at the campaign’s drawing board.
Neither Dr. Schlenker nor City staff would go into detail about what comments Sculley cited on Wednesday.
Dr. Schlenker was dismissive of the “offensive” comments, but declined to comment further.
“It’s just a smoke screen to avoid talking about the real issue,” he said. “(The sugary drink campaign) was a main bone of contention, Sheryl and I have been butting heads on that for over two years.”
Sources in the City said the comments had nothing to do with the failed campaign.
“This is not about sugary drinks,” stated Di Galvan, the City’s director of Communications, in an email. “This is a personnel matter. Dr. Schlenker no longer works for the City.”
City staff declined to comment further.
What he thought was a routine meeting on Wednesday turned into an ultimatum for Dr. Schlenker, who had been director of Metro Health since 2011. “‘Either sign this three-page letter of resignation that we’ve written for your or you can be terminated,’” he recalled Sculley’s straight forward request. “(There’s) no way I’d sign anything I hadn’t read or thought about.”
Dr. Vincent Nathan, who served as assistant director since 2012, will serve as interim director until a national search is carried out by City staff in the fall.
Schlenker said he was shocked by the decision to fire him, but added that perhaps he could have seen it coming – citing a recent City Charter amendment that passed during the May 9 City Election. It’s typical to clarify sections of code or charters that have outdated or inaccurate language. Sometimes policies become superseded by state law.
Proposition No. 4 easily passed with more than 80% approval, but most voters probably didn’t know about this item included in the measure:
Sec. 62. Public health department – Director of public health; qualifications
The director of the public health shall be the head of the department, who [He] shall be [a licensed physician and shall be] trained in public health administration.
Dr. Schlenker wasn’t consulted on the matter, he said, and only found out long after it had been approved.
“My dismissal had been planned for many months at least,” he said, adding that he did not find out about the change until long after the election.
Galvan stated that the City Charter edit was a simple housekeeping mechanism to remove an “obsolete requirement.”
“The Charter Review Commission recommended changing numerous outdated provisions. State law does not require a Health Director of a municipality to be a licensed physician,” she stated.
Under Dr. Schlenker’s leadership last year, Metro Health organized a working group to come up with a public awareness campaign that would reduce daily consumption of sugar. It’s an initiative that Dr. Schlenker has long advocated for and one that City Council can’t seem to get behind – most council members are weary of telling people what they can and can’t do, as Councilmember Joe Krier (D9) has said.
“I’m troubled by the nanny state – (the notion that) we’re going to pick something up and tell you that thou shall not eat it,” Krier said in April. “There is not a single cause that says ‘you do this and you’ll get diabetes,’” indeed there are many factors, not only overconsumption of sugar.
But the Center for Disease Control and Prevention considers over-consumption of sugary drinks to be a key target in controlling obesity, adolescent obesity and related diseases, such as Type II diabetes. While progress has been made in recent years, there is still plenty of work to be done: six of every 10 adults are overweight or obese in San Antonio and three of every 10 high school students are overweight or obese.
A majority of council members, including Mayor Ivy Taylor, would rather see a more positive approach – tell people what they could do to stay healthy, not what they have to do. For example, the City’s VegOutSA! campaign.
Big Soda fully supports such campaigns that promote healthy diets and exercise and denounce those that call out a specific culprit of obesity and diabetes like soda and other sugary drinks. Observers of the process have said this was what stalled – and eventually dissolved – the City’s sugary beverage campaign. While most of the working group supported a more aggressive, anti-sugar campaign, the Texas Beverage Association representative, Coca-Cola Company Director of Public Affairs and Communications Luisa Casso, refused to sign off on any message that connected soda to diabetes or obesity.
Meanwhile, Coca-Cola has been sponsoring outdoor and park initiatives across the city to the tune of more than $2 million in the last two years alone, leaving Dr. Schlenker and others with the impression of impropriety.
“I’m not against Big Soda or it giving money to the City, but not in exchange for vetting city policy and public positions – especially on something as important as diabetes,” Dr. Schlenker said, adding that the Coca-Cola representative Luisa Casso shouldn’t have been given veto power.
Members of the San Antonio Food Policy Council agreed.
“As a peer organization, we’re disappointed and apprehensive about the implications of funding for programming through the Mayor’s Fitness Council from the American Beverage Association. While their stated goal of selling primarily water is admirable, the majority of their member organizations’ billings come from the sale of unhealthy sugary beverages, so the likelihood of a counterproductive conflict of interest is dangerously high,” stated a spokesperson for the nonprofit organization in an email.
Where the City took pause, Bexar County stepped in and launched its own initiative, “Is your Drink Sugar-Packed?” that began this summer. The Bexar Healthy Beverage Coalition – formed by Bexar County, University Health System, the Health Collaborative, and other community leaders – did not include any representative from soft drink companies.
“We certainly applaud the desire to promote community health. But there is a bit of a missed opportunity here in that efforts that target one food or substance have proven ineffective long-term in spurring improvements in a community’s health,” Texas Beverage Association (TBA) spokesperson Katherine McLane said before the coalition’s announcement in February. “What’s proven more effective are holistic efforts that address health habits, that encourage balance and moderation in what families choose to eat and drink and their level of physical activity.”
Dr. Schlenker disagrees. The simplicity of the message to think about how much sugar is in a beverage is stronger than the shotgun approach of a message for moderation and balance. “Why focus on soda?” Dr. Schlenker asked City Council rhetorically last year. “Because 80,000 San Antonians have broken the everyday soda habit, and ending the daily soda habit is the first step to a healthier lifestyle. You have to start somewhere. … 64% of the people who live in San Antonio drink soda every single day.”
When we spoke on Monday, Schlenker was calm and reflective of his time spent at Metro Health. “I was bewildered for 24 hours or so,” he said. “But I’m feeling much better about it and talking with people has helped put it into context. I’m telling myself that it’s probably for the best … maybe it needed to happen.”
Since hired in 2011, Schlenker oversaw efforts that have reduced rates of teen pregnancy, syphilis, obesity, and diabetes – “but there is a lot of work to be done … a lot more going on than just soda,” he said.
The months-old Diabetes Collaborative, he said, is “probably the single most important activity that needs to continue” after he leaves. More than a dozen public and private health agencies are participating in the working group, including the San Antonio Food Bank, Baptist Health System, Humana, UT Health Science Center, and the YMCA of Greater San Antonio, with the lofty goal of taking down diabetes once and for all in Bexar County.
Looking forward, Schlenker – who has worked in medicine and public health for about 40 years – hopes to continue working towards a healthier San Antonio in any capacity. “There are many possibilities here.”
*Featured/top image: Metro Health Director Dr. Thomas Schlenker makes the case for a reduction of sugary beverage consumption during City Council’s B Session on April 1, 2015. Photo by Iris Dimmick.