Douglas Holt, Health Officer, Florida Department of Health, Hillsborough County

In an interview with Invest:, Douglas Holt, health officer at the Florida Department of Health, Hillsborough County, highlighted the region’s healthcare advancements and public health priorities. “We’re now 15th out of 67 counties in statewide health rankings, up from the mid-30s five years ago,” he said, citing progress in diabetes prevention, hepatitis A containment, and maternal health through the Strong Moms initiative.

What key highlights or milestones has the Florida Department of Health achieved over the past year?

The Florida Department of Health (DOH) is a statewide agency providing public health services to promote, protect, and improve the health of the community. DOH-Hillsborough, along with Pinellas and Pasco County health departments, serves the Tampa Bay region. At DOH-Hillsborough, we’re very excited about our county’s health rankings. We’re now ranked 15th out of 67 counties in the state, up from the mid-30s five years ago. These rankings look at things that impact people’s life span, such as unintended deaths, late cancer diagnoses, and infant mortality, or the number of babies that die in the first year of life.

Some areas we’ve focused on diabetes prevention and management — 93% of participants completed the program and lost weight. We have also worked on the reduction of tobacco use and the transmission of infectious diseases like HIV. We prevented a hepatitis A outbreak. Working with the Hillsborough Healthy Start Coalition, our Strong Moms initiative helps pregnant women have healthy outcomes.

Also, working with local hospitals, healthcare providers, public and private organizations, along with representatives of the community, we’ve completed the first step of a Community Health Improvement plan that is done every 5 years. This provides us with direction on where to prioritize our efforts to promote, protect, and improve the health of our community.

How would you assess the state of the healthcare sector in Tampa Bay, and what role does public health play in attracting businesses and talent to Hillsborough County?

There is a saying that a wealthy community is a healthy community. Public health focuses on populations, while hospitals and medical providers focus on individuals. Through collaboration and coordination, we can have the healthiest community. Hillsborough County is blessed to have an outstanding healthcare system, which provides our community access to the best care available. Tampa General Hospital, AdventHealth, BayCare, and HCA Healthcare are systems that have flagship hospitals here. Besides offering complex specialty care, they are also expanding primary care networks too. Moffitt Cancer Center is a top tier cancer research facility that provides world-class care. Orlando Health has also entered the region. The systems collaborate as community partners by promoting wellness messaging about screenings for cancer, diabetes, and other conditions. One of the best examples is that all of the CEOs serve on the board of Tampa Bay Thrives working to improve mental health. It is also important to recognize that we have an outstanding private medical community that serves as the backbone of the healthcare system. Finally, Hillsborough had a sales tax supported Healthcare Program that provides low-income residents access to care.

How are you addressing the needs of a growing population, and what challenges or opportunities has that growth created?

It certainly offers challenges. We have seen significant growth in the population. This has contributed to stresses related to increased cost-of-living and transportation that makes access to care difficult. The role of DOH-Hillsborough is to help people navigate and connect to healthcare, and make people aware of available resources and help them help themselves.

For populations where individual health could affect the community, we ensure they’re connected to treatment and maintain therapies. We help people get where they need to go and continue in care until there is no longer a risk to others. Community partners are critical. For example, we worked not just with healthcare providers but with neighborhoods and advocates to address opioid addiction.

How is your department partnering with the private sector to improve access to healthcare and preventive services?

That’s an essential part of our healthcare work. We fund partners to provide direct services, and we refer patients we’ve screened for breast, cervical, and prostate cancers to all networks, with close partnerships like Moffitt. Tampa General routinely tests all patients in their emergency department for contagious diseases like hepatitis and HIV, allowing us to connect people to treatment that improves their health and reduces the spread of diseases in our community. For HIV and hepatitis cases without primary care, we connect them to services.

I also want to mention that we also work closely with the public sector. One example is Hillsborough County Public schools. We provide funding for school nurses that provide medical and preventive services that greatly improve the health of our community. 

What is your assessment of Tampa Bay’s talent pool, and how is the department helping build a more resilient workforce in the region?

Tampa Bay’s talent pool for healthcare is top-notch. USF is the top medical school in Florida. We have large residency programs both at TGH and HCA that train new physicians, many of whom stay in Tampa Bay. We have excellent nursing schools too: USF, University of Tampa, and Kaiser University, among others. DOH-Hillsborough provides settings for students to learn and we even work with high-school students on healthcare career paths. 

What are your thoughts on healthcare costs, and how are factors like inflation, housing affordability, and access to care impacting public health in the region?

Healthcare costs are too high and rising. While the complexity of care we provide is costly, hospitals are investing in prevention — early diagnosis and injury reduction to lower expenses. Everyone is affected by inflation with the rising cost of housing impacting lower income and new residents. These factors impact access to care by making people hesitant to seek out care until they are very sick. As I mentioned, on the positive side, We’re fortunate to have the Hillsborough County Health Care Plan, a local indigent care tax that funds services for residents without private insurance or other public options.

How do you see Tampa Bay’s healthcare industry evolving, and what are your top priorities for the next two to three years?

All of the existing healthcare systems are expanding. New hospitals, urgent care and primary care clinics are opening all over Tampa Bay, bringing care closer to neighborhoods. When I came to Tampa in 1984, we had two or three hospitals. Our population was smaller and closer to these facilities. Over the last 30 years, the growth has occurred in areas that are no longer close to these original healthcare facilities. Transportation is a big challenge. Now expansion is occurring where the people live. Closer healthcare services greatly improve access to care. Looking ahead, we have an aging population. We’ll see more chronic and age-related illnesses such as cancer and dementia. Promoting healthy living with informed choices on eating and exercise, along with early detection of these conditions, must be a priority. We are making progress to decrease opioid and tobacco use. Reducing infant mortality will always be a priority, every death prevented is a precious life saved. We have all the tools to prevent new HIV infections. The priorities of public health are to reduce and better manage aging-related conditions while also working to ensure future generations are healthier and need less care.