photograph by karen pulfer focht
Dr. Michelle Taylor, a pediatrician who has advanced degrees in epidemiology and public health, became director of the Shelby County Health Department in 2021. “She was so well-prepared for this work,” said Yvonne Madlock, the former director who first hired Taylor in 2013, “as a pediatrician, her public health training, her military background, her drive and determination. She knew the work and the community.”
Just before the old health department building on Jefferson was demolished in 2021, the new health department director went back to the fifth floor to see her former office one more time. Her favorite map — a gift from a colleague when she got her first job at the health department in 2013 — was still on the wall.
The map depicted Shelby County’s 19 planning districts and 216 Census tracts. A map of the home she’d left and returned to so many times. She took the map to her new office.
“I love this map,” says Dr. Michelle Taylor, whose life and career have taken her all over the maps of the United States and Shelby County. “I love maps. You can explain so much with a map. Sometimes, when I give presentations, all I do is show maps.”
MEMPHIS MAP ILLUSTRATION BY KOSTIANTYN LEVIN / INGO MENHARD / DREAMSTIME
Public health professionals read maps like ancient mariners did. They use maps to chart currents of disease, forecast and monitor exposures and outbreaks, identify vulnerable populations, trace causes, and plan preventions and interventions.
In London in the 1850s, John Snow, the “father of epidemiology,” ended a cholera epidemic by mapping cases of infection and sources of drinking water to find the single polluted well that caused the outbreak.
In Baltimore in January 2020, researchers at Johns Hopkins University began mapping the spread of the SARS-CoV-2 virus, creating a comprehensive data source the world relied on to track and attack the biggest health crisis this century.
Taylor, who received her doctorate in public health from Johns Hopkins’ Bloomberg School of Public Health, and who became Shelby County’s health department director in 2021, during the pandemic, reads a lot of maps.
“I can walk through a hospital nursery and see all the babies lined up in bassinets,” says Taylor, who began her career in health as a pediatrician. “Except for little variations in color, they all look the same. But I can look at a map that shows which ZIP codes those babies are from, and pretty well predict how long each baby will live. That’s tragic but it’s also helpful. The map shows us that we can do something about it.”
Taylor, former White Station High homecoming queen, major in the Air National Guard, breast cancer survivor, and divorced mother of two, has a lot of plans to do something about it. She has mapped the city’s biggest public health challenges. Disease. Poverty. Violence. Mental illness. Substandard housing. Malnutrition. Systemic racism. She has charted a course to put public health at the center of that map.
“Most people think of the health department as the place you go to get birth or death certificates, or the place you go to get treated for STDs. Let’s just be real,” Taylor says. “Public health touches every aspect of this community. Public health can’t save Memphis, but Memphis can’t be saved without public health at every table. If people didn’t learn that from Covid, that lesson will be learned again and again.”
Taylor’s life has been mapped out since her parents gave her a toy doctor’s kit when she was 5. She told her mother she wanted to be a nurse. “Yes, baby, you can be a nurse. That’s a worthy profession,” her mother told her. “But have you thought about being a doctor?”
Taylor has been thinking about, and asking questions about, medicine and public health ever since. When she was 9, her 3-year-old cousin, a patient at St. Jude Children’s Medical Center, died of leukemia. “I had all these questions about how and why he was sick, and nobody could really answer all my questions,” Taylor says.
Questions still drive Taylor. For example, why are young Black women more than twice as likely to die from breast cancer than other women? Why do Black women have a 40 percent higher death rate from breast cancer?
When she was 11, her military parents moved back to Memphis from California. She spent a lot of time with her extended family. “My granddad was in the Army, a very smart man, an avid reader, but he was addicted to heroin and alcohol,” Taylor says. “I used to ask him questions about his addiction, like I was trying to diagnose him.”
When she was in middle school, her mother’s identical twin sister died of breast cancer at age 34. “I had so many questions,” Taylor says. “I just needed to understand what happened and why. How does a young, healthy woman get so sick and die?”
Questions still drive Taylor. For example, why are young Black women more than twice as likely to die from breast cancer than other women? Why do Black women have a 40 percent higher death rate from breast cancer? Why is breast cancer more deadly in historically Black and poor Delta counties along the Mississippi River?
Racial disparities persist, as Taylor is painfully aware. Breast cancer has plagued her own family. More than two decades after her mother’s sister died of breast cancer, Taylor’s mother was diagnosed with it in 2011. In 2016, Taylor herself got the bad news from her radiologist husband, Dr. Eddie Taylor.
“He called me at work,” she says. “I stepped out into the hall. He started reading the biopsy results. He just choked up when he got to the part about how invasive it was. I said, ‘Okay. I’m leaving. I’ll meet you at the house, and then we’ll drive out and tell my mother.’ When I got off the phone, I just lost it. I started sobbing. But I knew exactly what I wanted to do. It’s almost as if I had been preparing my whole life for that moment.”
Doctors found two malignant lumps in Taylor’s right breast. She wasn’t taking any chances. Her aunt died when her cancer returned after a lumpectomy, radiation, and chemotherapy. That experience informed Taylor’s mother, who was diagnosed with Stage 0 cancer. “Take it all off,” her mother had told her oncologist. “Double mastectomy with reconstruction,” Taylor told hers.
Surviving breast cancer made Taylor more aware of her own privilege: The speed of her diagnosis. The quality of her care. The personal attention she received from her fellow medical professionals. Her own knowledge and experience. Her ability to take a year’s leave of absence to recover from three surgeries.
“I had a lot of advantages that most women, especially most African-American women, just do not have,” Taylor says. “For me, it crystallized how much more work we had to do. One of my goals is to make sure that every African-American woman, every woman period, has access to that kind of high-quality and timely care, and can be informed and confident enough to advocate for herself.”
The experience also made her more aware than ever of the support system she’s always had around her. “I thank God every day for my family, my village, everyone who was there for me to make sure I got back on my feet as quickly as possible and healed in the most complete way,” Taylor says. “Everyone should have that kind of support system.”
photograph by karen pulfer focht
Taylor and her mother, Rita Works, are Air National Guard officers and breast cancer survivors. They help each other train and recover, physically, mentally and spiritually. “I was pregnant with my daughter when my mother was diagnosed,” Taylor says. “I was just boohooing. My mom calmed me down. She’s super sweet but tough. She kept saying, ‘I’m going to be fine. I’m going to get better. I’ve got to hold this baby girl we’re about to have.’”
As Taylor has navigated her life, her parents have been her pole stars.
Her mother, Rita Works, a retired major general in the Air National Guard, taught her daughter to be confident, disciplined, pragmatic, and persistent. “You might know better than anybody else, but you’re no better than anybody else,” she told her.
Her father, Marvin Morgan, an IT consultant, taught her to be curious, creative, dedicated and giving. “Satisfaction is more important than success,” he told her. “Success is what others judge you by. Satisfaction is what you judge yourself by.”
The young woman who “bombed” her medical college admission tests went on to earn a medical degree, a master’s degree in epidemiology, a master’s in public administration, and a doctorate in public health.
Rita and Marvin grew up in South Memphis, met as teens working at Woolco on South Third, were married in DeSoto Park, then moved into the world. Marvin joined the Air Force, and Rita did the same a few years later. They moved from their home base in South Memphis to military bases in North Dakota (where Michelle was born), Alaska (where her brother, Marvin Jr., was born), then California. Both of her parents earned college degrees along the way.
Marvin became Morgan Keegan’s IT director and the company’s first Black executive. Rita became the first Black female officer in her squadron. “When I left Memphis, my world was black and white,” says Works. “I had to go someplace else to understand the dynamics of various ethnicities and worldviews. The military gave us a world view.”
The family brought their world view back to Memphis when Michelle was 11. “It was culture shock for Michelle,” says Works. “It took her a year or two to get acclimated. She had to learn how to take care of herself. I grew up in South Memphis, so I knew. You don’t have to start a fight, but you can try to finish it.”
The lessons paid off. The girl who was bullied in elementary school was elected homecoming queen. “She was well-liked, but she also was highly respected,” says U.S. Attorney Kevin Ritz, one of her classmates. The popular student who fretted about making A’s won scholarships from Stanford and Vanderbilt, among others. The young woman who “bombed” her medical college admission tests went on to earn a medical degree, a master’s degree in epidemiology, a master’s in public administration, and a doctorate in public health.
“She just doesn’t give up,” says her father. “One time when she was in high school, I was working on a hard drive that was giving me fits. It was about 1:30 in the morning and I was tired, so I decided to go at it the next day. I went upstairs and found Michelle still up studying. So I went back and finished the job.”
This is the sixth time Taylor has returned to Memphis. Every time she gets pulled away, something or someone pulls her back. “I have a friend who says the river calls you home,” she says. “I guess it keeps calling me.”
Taylor lived here as a toddler while her mother finished her degree at Memphis State. “We couldn’t afford a babysitter, so I’d take Michelle to class with me,” Works recalls. “She’d sit in the back and learn right along with me.”
Military obligations pulled them away. Family concerns, in particular the poor health of her aunt and grandmother, pulled them back. College pulled her to Washington, D.C. The river pulled her back. After graduating from Howard University in 1997, Taylor spent a year teaching science at Fairley High School, her mother’s alma mater. “I learned so much from those kids,” Taylor says. “You want to talk about the social determinants of health? Just walk into a classroom.”
Medical school pulled Taylor to East Tennessee State University, where she met her husband. The river pulled her back. She worked here for several years as a pediatrician while earning a master’s in epidemiology at the University of Tennessee Health Science Center.
Public health pulled Taylor to Baltimore and Johns Hopkins in 2009. “Their motto is ‘Protecting Health, Saving Lives – Millions at a Time,’” Taylor says. “You can’t be there and not think you’re saving the world.”
During that time, a Memphis family friend encouraged her to enlist in the Air National Guard. “I just talked to Michelle about all the good she could do, and what an opportunity it was for her to learn in a different way. She’s a lifelong learner,” says Dr. Jan Young, executive director of the Assisi Foundation in Memphis, and a retired major general in the Air National Guard. Young and Taylor’s mother were members of the same air wing.
In 2013, public health pulled Taylor back to Memphis. Yvonne Madlock, the county’s longtime health department director, hired Taylor to be associate medical director and deputy administrator for maternal and child health. “She was so well-prepared for this work,” Madlock says, “as a pediatrician, her public health training, her military background, her drive and determination. She knew the work and the community.’
Taylor led the department’s successful initiative to reduce infant mortality. Among those she enlisted to help was Dr. Altha Stewart, a local psychiatrist and UTHSC professor who has devoted her career to addressing mental illness in youth. “We soon found out we have a past,” Stewart says. “Her father and I played together as kids in South Memphis. I’m tremendously proud of what she’s done. Her focus on mental health as a public health issue gives me great hope.”
photograph by karen pulfer focht
The health department hosted a free, drive-thru pet vaccination clinic in late April, the first since before the pandemic. Taylor’s plans include renovating and expanding the department’s six public health clinics, including this one on Sycamore View. “No matter where you live, you should know you’re getting high-quality health service and good customer service,” Taylor says. “We’re still working on that.”
When Madlock retired in 2015, Taylor applied for her job. “I got no response,” Taylor recalls. “I heard they thought I was too young and inexperienced. But I guess it was a blessing in disguise. I got my cancer diagnosis in January 2016. I still had more growing and learning to do.”
In 2017, higher education pulled Taylor away from Memphis again, this time for a minority health policy fellowship at Harvard University’s Kennedy School. It was a heady experience. “You’re sitting in class with people you know will be running for office and making health policy decisions for the entire country,” Taylor says.
When she completed her master’s in public administration, her fourth advanced degree, her parents, now divorced, told her she had educated herself out of a job in Memphis. Taylor moved to Washington and worked for the surgeon general of the Air National Guard in the nation’s capital. She was living with her children, Malik and Ella, and her mother, near her father and her “bonus mom” (“I don’t do steps”) in Maryland.
Taylor runs a health department in a majority Black and blue city in a majority White and red state. Politics will continue to be a challenge. She’s frustrated by the legislature’s rejection of billions of federal dollars to expand Medicaid and millions to curb the spread of HIV, by its interference in medical decisions to restrict abortion and care for transgender youth, and by its refusal to address gun access and violence. “In what world does that make sense?” Taylor asks.
In February 2021, a year into the pandemic, Taylor’s former husband and her mother both sent her a link to a news story in Memphis. Shelby County Health Department Director Alicia Haushalter, who succeeded Madlock, had resigned. The river was calling. Taylor loved living near her father. She also loved the idea of her children living again near their father. “My ex-husband and I are still best friends,” Taylor says. She loved her work in Washington. She longed for the work in Memphis. “My desire to be health director in my hometown had not left me,” she says. She applied for the job.
Taylor was one of two finalists, but her appointment hit a political speed bump when a leaked memo said the search panel had not recommended either finalist. Taylor was “very articulate” and “highly credentialed,” but “weak on how she plans on changing the health department,” the memo said. The memo was soon discredited, and the commission unanimously approved her appointment.
The incident gave Taylor her first lesson in how the pandemic has politized public health. A few months later, she got another. In November 2021, the state legislature revoked the health department’s authority to require masks or proof of vaccination. In the weeks after, local cases of Covid-19 skyrocketed. “I got so angry,” Taylor says. “I guess I ruffled some feathers because I actually read. We’re trying to follow the science. How can you pass a public health law that restricts what we can do to protect public health?”
Pandemic politics has caused other problems. Taylor and her staff have been verbally harassed, spit on, pushed, and threatened. An anti-vaxxer showed up on Taylor’s front porch yelling at her. Twice she left her house with a security detail. As the pandemic and related threats have subsided, new challenges have emerged.
Taylor runs a health department in a majority Black and blue city in a majority White and red state. Politics will continue to be a challenge. She’s frustrated by the legislature’s rejection of billions of federal dollars to expand Medicaid and millions to curb the spread of HIV, by its interference in medical decisions to restrict abortion and care for transgender youth, and by its refusal to address gun access and violence. “In what world does that make sense?” Taylor asks.
In a politicized world. “Oh, my, she’s got her work cut out for her,” says Young. “But, however many people have doubted her ability to navigate the political landmines in that job, they will find out that she’s more than up to the task. She worked in Washington. Politics up there is three-dimensional chess.”
Public health has saved Memphis before.
The city and its citizens suffered waves of deadly cholera, dysentery, smallpox, and yellow fever outbreaks in the nineteenth century. The city’s health director was one of more than 5,000 victims of the yellow fever epidemic of 1878.
The epidemics then finally pushed officials to make public health a priority. They passed strict new sanitation laws outlawing open privies, regulating animal pens, and installing a revolutionary sewer system. A decade later, they discovered a massive underground aquifer that still supplies fresh and safe drinking water.
“This community wouldn’t have survived without public health,” Taylor says. “It still won’t.”
“I’ll be honest,” Taylor says. “Environmental justice was not completely on my agenda when I first got here.” It is now. “I understand the community’s frustration. I’m frustrated. Environmental racism is real, but it didn’t develop overnight. It won’t be solved overnight.”
Taylor’s latest challenge has little to do with politics and everything to do with public health. Last August, the EPA dropped an environmental health bomb on people who live near Sterilization Services in South Memphis.
In a letter to residents near the facility, the EPA announced that the company, in business since the 1970s, was using an EPA-regulated chemical called ethylene oxide, or EtO, to sterilize medical equipment. The letter noted that the chemical’s cancer-causing risk is 30-60 times higher than the EPA previously thought, but added that the facility was following federal regulations.
The letter failed to explain that the EPA had known about EtO’s elevated cancer risk since 2016, that 85 percent of EtO emissions escape the facility through vents, doors, and windows, that EPA regulations don’t account for those “fugitive” emissions, and that the EPA had been planning to strengthen those regulations since 2019 but had not yet done so.
“Our regulations are not protective enough. The rules are not good enough,” Madeline Beal, EPA’s senior risk communications adviser, told residents at a public meeting last October.
Taylor was not prepared for the fallout. Residents, led by Memphis Community Against Pollution, have demanded that the health department order the company to reduce EtO emissions immediately. Taylor says the health department doesn’t have the authority to do that until EPA’s proposed tighter regulations are in effect, a process that can take up to three years. The company has declined to respond.
Meanwhile, Taylor is turning to maps to assess and monitor the danger. In March, the department released a series of color-coded maps that “found no evidence” of higher cases of cancer near the facility. Taylor has asked the CDC to conduct a public health assessment of the neighborhood. She also launched a countywide cancer study.
“I’ll be honest,” Taylor says. “Environmental justice was not completely on my agenda when I first got here.” It is now. “I understand the community’s frustration. I’m frustrated. Environmental racism is real, but it didn’t develop overnight. It won’t be solved overnight.”
Racism is one of the social determinants of health, “conditions in the places where people live, learn, work and play that affect a wide range of health and quality-of life-risks and outcomes,” according to the CDC.
Taylor believes public health can and should address them all. She lives in a place where birth and death certificates were color-categorized by race at least until 1968. A place where people on average live 20 years longer in some ZIP codes than others. A place where race, income, and other social conditions still determine which babies are more likely to live long, healthy lives.
“All of the social determinants of health are products of what I call the ‘policy determinants of health,’” she says. “There’s a reason there are 26 other major and minor pollution emitters in a particular part of South Memphis. Structural racism exists because laws built and still support those structures. Public policies allowed polluters to locate in that area because that’s where black people lived. You can see it on a map.”
David Waters, a veteran Memphis journalist, is associate director of the Institute for Public Service Reporting at the University of Memphis.
