America's North Shore Journal

I am cur­rently involved with what may be the largest Pub­lic Health effort under­taken in Mon­roe County and Rochester, New York, in decades. I am vol­un­teer­ing for the H1N1 vac­cine clin­ics being held by the county this week.

This, and my nor­mal cov­er­age of health issues, has brought to a head some thoughts on Pub­lic Health agen­cies and prac­tices I have been mulling for some time.

In a series of posts, I will try to point out where we have gone wrong, what needs to be fixed and what is right with the system.

The Mon­roe County Depart­ment of Pub­lic Health has 239.5 FTE posi­tions and its bud­get for the cur­rent year topped $68 mil­lion. That's about 7.5% of the total county budget.

Every local­ity and level of gov­ern­ment will have some­thing sim­i­lar. The states do, and so does the Fed­eral Gov­ern­ment. The duties of each pub­lic health agency will vary, and the fund­ing pro­vided the agen­cies to per­form these duties will, as well.

As tax­pay­ers and vot­ers, we expect the national and state-wide Pub­lic Health agen­cies to address prob­lems that reach beyond our neigh­bor­hood. The agen­cies at the city, town or county level are sup­posed to be focused on pub­lic health issues in our local communities.

The prac­tice of Pub­lic Health has some great vic­to­ries in its his­tory. Malaria, typhus and yel­low fever were dri­ven from large parts of the planet. Small­pox was made extinct in the wild. Polio was largely defeated and nearly ren­dered extinct.

But, now, the men and women in the Pub­lic Health busi­ness face a dif­fer­ent set of chal­lenges. New and deadly ill­nesses com­pete with old ones that are mak­ing a come­back due to soci­etal changes. Pub­lic Health is seen by many as more than just dis­ease pre­ven­tion, and issues such as gun vio­lence and obe­sity are added to the agenda.

The direc­tion for government-supplied Pub­lic Health ser­vices in this coun­try is unclear. The cur­rent Swine Flu pan­demic rep­re­sents, in micro­cosm, all of the good and the bad that is mod­ern Pub­lic Health. Stay tuned for more in this series.

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