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.