Jefferson County health officer Dr. Mark Wilson, one of the region’s most prominent and influential voices during the height of the COVID-19 global pandemic, has informed the Department of Health that he will leave the position no later than the end of 2023, sooner if the department finds a successor before then.

Wilson, 60, who became health officer in 2011, cited professional and personal reasons for the decision.

“It is generally a good idea for somebody in this position to not stay in office too long,” he said. “Periodically it’s healthy for an organization to get fresh leadership, for there to be a new perspective, maybe a new skill set, just a different way of seeing things. To hit the reset button for the direction of health department leadership and the health department.”

Wilson says he began to consider the move prior to the onset of the pandemic in early 2020.

“I wasn’t planning to step down at that time,” he says. “It was just something I was thinking that at some point in the not-too-distant future might be a good idea. Then the pandemic hit and of course, there was no way I would step down right in the thick of that. But as the pandemic was waning as was the intensity of our response—maybe a year ago or a year and a half ago—I started thinking more seriously about stepping down.”

Public health officers – Wilson is one of only two in the state who operate independently of the Alabama Department of Health — are typically anonymous, overseeing various programs, and practices and attempting to influence policies to improve health outcomes.

Contending with a monumental health crisis is “certainly part of the job description,” Wilson said. “It’s just that we don’t see an event like this come along very often. Also, what made it different really was the public awareness, the visibility. A lot of public health has been working quietly behind the scenes. There’s a health officer doing things, but they’re not in everybody’s life every day. The pandemic was in everybody’s life every day.”

And Wilson was at the center of every discussion and sometimes controversial decisions regarding business and school closures.

“Of course, the intensity of the work and the urgency of the work and having to juggle a lot more balls all at once was different than what we would typically see,” he said. And having to mobilize so many resources within the health department and outside of the health department around one common enemy is completely different from the way we normally operate.”

More than 2,500 Jefferson County residents have died from COVID-19 since March 2020, and more than 230,000 positive cases have been reported during that period.

“The pandemic did take a toll on me,” Wilson said. “Now I don’t want to pretend like I’m unique. It took a toll on everybody. I don’t want to, you know, single myself out as being special in any way. It just took a little bit of the gas out of my tank. I don’t quite have the same level of energy and drive to do the work that needs to happen going forward. I think it would be good to have somebody who has more energy and drive, more in their gas tank.”

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In December, Wilson, and his family were touched by their own tragedy—the death of their oldest daughter, Laura, by suicide. At the time, Wilson wrote on social media: “She suffered from chronic anxiety and depression and had a history of previous suicide attempts. For those who haven’t experienced how bad depression can make you feel it’s hard to imagine, but she obviously reached a point where she just couldn’t bear it anymore. I think she had tried very hard because she didn’t want to hurt those who love her. In her suicide note, she said, ‘I’m sorry.’ Typical of her to not want to disappoint others.”

This week he said: “The death of my daughter, which I don’t mind, mentioning—I’ve been very transparent about that—that is not the reason I’m stepping down. Some people have asked me that. They’ve expressed concern and just encouraged me to be careful not to make a decision as a reaction to the grief I’m going through. Conventional wisdom is you don’t make big life decisions when you’ve had a major loss in your life and you’re grieving. I had already been thinking about stepping down, within the next year or two before our daughter’s death. It is not the reason I’m stepping down but it may have accelerated it by a few months.

“It took a little bit more gas out of my tank.”

Toughest pandemic challenge

Laura’s death also followed what Wilson terms one of the most difficult challenges through the pandemic: offering guidance on the reopening of schools.

The discussions began in the summer of 2020.

“I was asked by public school superintendents to provide them with more specific guidance beyond what the state had provided on what they should do for reopening,” Wilson recalled. “That’s when I offered guidance. It was not an order. I refused to give orders to school boards. I labeled it guidance or a recommendation—it was one of those words—in a letter that basically recommended that elementary-aged kids go to school in person with masks on, which was consistent with the state recommendations. And that the middle school and high schools either do virtual or hybrid alternate day schedules in order to reduce classroom size by at least 50 percent and of course wear masks.

“I consulted with the school superintendents and gave them a draft of that ahead of time. And we discussed it together before I made it public. So, it was a collaborative process, but at the same time, it was a little more dramatic than some of them had expected. The draft was labeled confidential, but it was leaked out.

“There basically followed a firestorm after that of a lot of parents who were very upset. That was, let’s say, aside from the trauma related to my daughter, probably one of the most difficult weeks of my life. That was pretty, pretty difficult for me and again, it’s difficult for everybody, but there were a lot of angry people.

Although the pandemic dominated his tenure, Wilson cited numerous other accomplishments.

“I would almost like to deemphasize COVID,” he said. “It was a very intense and dramatic part of my tenure, but it was only a small part of the overall work that was done around multiple issues in public health. A lot of what we had been doing before the pandemic and what we’ll continue to do is focusing on the things that most affect people’s health—the health behaviors, like exercise and nutrition and avoiding harmful substances, getting appropriate screening for diseases. That’s all very important. We’ve done a lot of work in those areas.”

Wilson also noted the “major work” in encouraging smoke-free policies. “Most of our municipalities now have smoke-free policies that were passed early in my tenure,” he said.

There were also efforts to address the heroin epidemic and the opioid crisis — a law passed in a 2015 bill that provided immunity for providing opioid antagonists, like Naloxone; another passed in 2022 making fentanyl test strips legal. And the establishment of the Recovery Resource Center, which offers navigating addiction treatment. “We know we’ve saved lives from opioid overdoses,” he said.

“Improving infant mortality and the disparity between Black and white for babies surviving to their first birthday–huge priority,” Wilson added. “We established two new programs to assist lower income at-risk pregnant women through their pregnancy and the early part of the baby’s life. Those are community partnerships we helped make happen. I’m just reminding people what some of the big issues have been: tobacco, obesity or lack of physical activity and healthy eating, infant mortality, health equity, air quality, violence, and homicides. They are all things we’ve embraced and are working on actualizing more.”

“I think I have accomplished a lot,” Wilson continued. “I’ve done a lot of good. A lot of it has been outward facing. I think the department may need somebody that can still do that sort of thing, but maybe pay a little more attention to the inner workings of the department and the operation of the department, and the structure of the department. It’s time for somebody to come along that might just have a different set of skills and talents, maybe experience and training to fill in some areas where perhaps I was not the strongest, the compliment some of the work that I’ve done, or maybe to catch up on some of the things I’ve not done.”

Wilson says he is “not nervous” about his future and, after a few months of rest, plans to return to practicing medicine. “I want to be a regular doctor,” he said. “I still enjoy taking care of patients.”

Note: If you or someone you know is contemplating suicide, reach out to the 24–hour National Suicide Prevention Lifeline at 1-800-273-8255; contact the Crisis Text Line by texting TALK to 741741; or chat with someone online at suicidepreventionlifeline.org. The 988 Suicide & Crisis Lifeline is available 24 hours.