Dr. Sanmi Areola is a veteran in public health, having served in leadership positions in Nashville, Johnson County, Kan., and in Prince George’s County, Md., before returning to Nashville in 2025 to lead the Metro Public Health Department (MPHD).
Areola holds a PhD in environmental toxicology and started his career doing a lot of research and lab work.
“Sometimes there is a divide between the lab work, the research, and how it translates into practical changes at the community level,” he said. “I started looking for an opportunity where I could use those scientific skills, training and learning in a way that is more impactful.”
In 2002, he saw a job description at MNPD, which he considered his opportunity to make a difference at the community level.
After being gone from Nashville since 2020, what made you return?
Nashville is really where I started my post-lab research career. It is where my kids grew up.
While I believe I was very helpful in Johnson County during the COVID years and did all the things that needed to be done to ensure that we protected the population from the impact of the once-in-a-generation pandemic. While I absolutely loved working there and creating conditions that people can be impartial, when the opportunity came to come back to Nashville, it was enticing.
The teams were here; the connections were here; I knew the department; I know the staff because in the 18 years I was here, I played a lot of different roles. There is very little in public health that I haven’t been directly involved in over the years. And so the connections in Nashville, the relationships in Nashville, the relationships with the community, with elected officials, policy makers and with the state, with nonprofits, it was very difficult to say no to coming back to Nashville.
In the almost seven months I’ve been back here, I am glad that I am back. So many opportunities to create conditions where everyone can be healthy. So many opportunities to improve health for everyone. So many opportunities to provider leadership within the department to make sure that the department is functioning optimally. So many opportunities to make sure we are providing the best customer service, not just internally but externally. So many opportunities to build even stronger trusting relationships with the community.
That’s why I’m here.
After your first seven months back, what are your top priorities for the department?
The key thing in public health is that no matter where you go or do public health, it is very important to understand the dynamics of the place and to understand what the key issues are. In Nashville, from my job interview to now, there are some key issues that are hugely important to the public, important to the Mayor, and important to the Board of Health, as well as elected officials.
One is addressing the community safety, the community violence issue. And that’s really right on top of the things I am looking at. There is a lot of good work around there going on, I have to say. There are investments that are being made. The staff of the Metro Public Health Department have been working in that area.
And so, part of my goal in the next few months is to put that together in a way to create a Community Violence Plan for the county. If we have a five-to-ten-year plan that guides what we do and that will dictate where we will put our resources in as a county, that will help us focus a lot of the efforts.
The second area is around opioids. Opioid and substance use continue to negatively impact our residents. The good thing is that we do have some resources around that. We have the opioid settlement funds. So, part of my goal is to take a strong look at those and to make sure that we use these resources to build the right infrastructure for us, from educating early on to prevent the development of addition to ensuring that those who are already addicted also have resources that are available for them to reduce harm and offer treatment.
Those are two key things that I feel are important to the county.
The other part is that we continue to [focus] on infections related to tuberculosis (TB), syphilis and congenital syphilis, and HIV. The good thing again is we have so many available programs that are already impactful in those areas. So what we’re doing right now is understanding the data better and developing new strategies so we can change those trajectories.
The mission of the Metro Public Health Department is “to protect, improve and sustain the health and well-being of all people in Nashville and Davidson County.” That is a very broad mission statement and a big task. How do you tackle that?
I absolutely love the way you phrased that question. I am going to underscore the word “broad.” That’s public health. Public health is very broad. It is impacted by several factors.
Protecting, sustaining, improving health – these are things that we have to do collectively as a society, as a community. It is broader than the scope and the ability of just the Metro Public Health Department. It is why relationships with the community, with not-for-profit organizations, with academia, with other government entities are absolutely crucial.
For example, in Nashville, we have the Health and Wellness Council here that is working on aspects of things that we, as a Health Department, don’t necessarily do. That’s why we collaborate with entities like NashvilleHealth that is working on programs around [zip code] 37208. Those things are not the sole responsibility of the Health Department. It is our job though to be the convener in some cases. It is our job to act as the health strategist. But to do those things we must be intentional about involving the entire community.
Everything I’ve been talking about, from community violence to opioids to TB to HIV, we cannot deal with those things by ourselves. I have not seen a single not-for-profit organization that is not done out of a need in the community. They understand the community better than we do. They understand the needs. They understand the norms and the values. So to be effective, to be impactful, to be able to do all the things around protecting and improving and sustaining the health of residents, we have to be intentional in engaging the entire local public health system.
What are your priorities for the next five years?
I think the biggest part is building trusting and strong relationships with the community. I will give the example of COVID. We cannot afford to wait until we have a pandemic before we build relationships. We develop vaccines, and we’re ordering vaccines to the public, but we have communities that really don’t trust what we are doing because we haven’t been intentional in developing those relationships. So the biggest thing for me is building strong, trusting relationships with the community, and being intentional about those communities that are not typically at the table.
The second thing for us is to ensure that [we are] creating conditions that provide the opportunity for everyone to be as healthy as they possibly can. That means that we are intentional in our strategy. We’re intentional in our approach to ensure we are creating what I call health for everyone.
I’m just going to borrow [a phrase] from the Robert Wood Johnson Foundation, which is to build a culture of health. For example, if you want people to be able to be active, then you create conditions around their homes and neighborhoods that allow them to do that. You want sidewalks that are well-maintained, that are properly designed. You want people when they step outside their home not to be afraid for their safety.
That’s creating a culture of health.
If you want people to eat healthy, make sure they have the grocery stores that they can access, make sure that they have transportation to go see their children, to go to grocery stores, to go to their doctor’s appointment. So, it’s working with different entities to make sure that we are creating a culture of health in the county.
Again, those impact multiple health endpoints. And of course the first thing then is to address specific issues in the county: 1) Community wellness; 2) Opiate substance use; 3) TB; 4) Syphilis, HIV and other STI’s (sexually transmitted infections); and 5) address chronic diseases. They are still some of the leading causes of morbidity and mortality in the county, whether we are talking about cardiovascular health. Whether we are talking about diabetes or obesity. These are all tightly linked to all of the factors I mentioned before, like addressing issues of food deserts. But those are the things that we have [to figure out] and they are the things that are on top of the priorities for the next five years.
What is the most urgent issue for Nashville to tackle in terms of public health?
Community violence.
It’s difficult to say that one thing is more important than another because as a department, we do so many things. And so, when I comment on one program, it means that we have many other, very important programs we are doing under control.
However, you asked me what are the priorities for us in addition to other impactful things that we do, I would say community violence.
How do you define community violence?
It does mean a lot of things and as a community we have to define what it means to us. To some it’s gun violence. To others it’s addressing upstream factors of public safety. So that’s part of what we’re going to try to do as a community is [define what it is.]
Community violence, community safety is a very broad theme and there are probably multiple complements to that. I do not want to necessarily exclude any part of it. The question though for us is, what part of it do we want to focus on.
For me, upstream factors are important, and they impact all these multiple ways that we are defining that. If we create environments where our kids can thrive; if we create after school programs for our kids; if our kids have community centers and parks to play in, it wouldn’t matter that much how we are defining [community violence]. After all, for me, the kids are products of the environment in which we allow them to grow up in.
So rather than necessarily narrowing myself into whatever definition people have out there, it is more of a focus on creating conditions that allow our residents and our kids to grow up in [healthy and safely]. If we do this … then whatever the vision people choose to focus on will be impactful in ensuring that our kids are trending to towards the positive experience rather than the negative experiences.
Do you think the city is ready for the next pandemic?
Yes, I believe we are ready because we have an experienced, well-trained workforce. We learned from this huge pandemic. In my seven months [back in Nashville], I am happy with the workforce, I am happy with the landscape. I’m happy to have the relationships that we built before, during, and after the pandemic. We continue to nurture those relationships. Those relationships with the community are important now. They’re even more important when we have to respond to events like [a pandemic].
And so there is the science piece, there is the relations piece, and I believe we are very well positioned to do both.
So science plays a role. But equally important, maybe even more important is to understand what the community is willing to tolerate. We have to take that into consideration in making public health decisions moving forward.