Creating a County Health Department

By John F. Innelli

Delaware County is the largest county in the state of Pennsylvania without a county health department. Of the counties with populations over 500,000, we are the only one without such a department, and the consequences on our health have been severe and incontrovertible. It is the prerogative of our County Council to create a County Health Department, but despite overwhelming evidence to the contrary, our Council claims that the residents of Delaware County do not need one.

The Facts:

• Delaware County has one of the highest rates of death due to influenza and pneumonia, but one of the lowest percentages of people receiving influenza and pneumonia vaccines in the state.
• The Southeast Region of our county has higher rates of childhood asthma than the rest of the county, with an abnormally high rate of 10% -- in some school districts the rate is as high as 20%.
• Delaware County has the third highest cases of AIDS in the Commonwealth, even though we have the fourth highest population by county.
• Our county has the highest death rates from cancer and stroke in the entire Commonwealth.
• The principle source of our county's drinking water + the Springton Lake Reservoir + is surrounded by aging septic systems and new housing developments that pass filtered waste into the feeding streams. The County does not have the capacity to properly inspect them.
• Restaurant inspections are left to the local municipalities, many of which do not have certified inspectors. Furthermore, there is no public record of which restaurants have passed or failed inspection.

• Our county is supposed to have a 4,000 member-strong Medical Reserve Corps, which, in case of an emergency, is charged with dispensing medication to the entire population the entire population of the county within 48 hours. Currently, the Medical Reserve Corps of Delaware County does not exist.
• Less than 30% of our schools have a school nurse-to-student ratio of 1:750, about half of the statewide average, and one of the lowest ratios in the Commonwealth. Proper communication between school nurses and a county-wide health department could prevent a potential health emergency from occurring.
• Besides the PA Department of Health, which is one of the most overburdened health departments in the nation, our county has no infectious disease monitoring on a county level. This means the coordination between hospitals and key health care facilities to track problems and quickly work on solutions does not exist in Delaware County.

• Just one year ago, the water supply of Riddle Memorial Hospital became contaminated. Because of this, the Hospital went without water for three full days. Outrageously, with no county authority to respond to the emergency, the PA Department of Health was unaware of the problem for 36 hours, and even then no team was sent to respond. Patients and their families tried in vain to notify local townships for help, not knowing where else to turn. The County Health Department would be the logical solution.
• Recently, Aston Township's sewer system failed, potentially exposing residents, including children and the elderly, to raw sewage. Without a County Health Department, no immediate action was taken by the county or the state. Only after being reported in a local paper did the PA Department of Health investigate.
• Since 1994, the ground and groundwater of Seaside Ave. in Upper Chichester has suffered contamination from the underground tanks of a Getty Station and a recent fuel spill there. For years, residents have complained about their health concerns, but only after the recent spill has any public health agency responded. At this point, however, no one from the County has monitored, identified, or provided a solution for the residents. Again, this is ideally the work of a County Health Department, but none exists.

How a County Health Department Will Make Us Safer and Healthier

The Working Group for a Delaware County Health Department provides this analogy:

"A public health department is like a police department. This is not a partisan issue. In an editorial dated October 24, 2007, the Delaware County Daily Times became just the latest organization voicing the urgent need for a County Health Department, joining countless other groups and individuals across the County. It is the first responder in a public health emergency, and it also helps to prevent disease outbreaks by monitoring and targeting areas of concern."

With a County Health Department certified by the Center for Disease Control and Prevention (CDC), Delaware County will be able to:

• Properly inspect restaurant and food service establishments, taking the burden off of individual municipalities
• Investigate and track threats to public health, such as infectious disease outbreaks, threats to the water supply, insect-borne diseases, and industrial pollution
• Develop county-wide plans to respond to health emergencies
• Develop and administer county-wide plans to respond to health emergencies
• Develop and administer county-wide health improvement programs in such areas as childhood vaccination, smoking cessation, HIV testing & education, nutrition, and hypertension

Because of state and federal programs that encourage the creation of County Health Departments, the cost of creating one is much lower than one may think + despite Republican claims to the contrary. Under PA Act 315, Delaware County is due to receive 50% of the money for a county health department from the state government and an additional $775,000 for environmental concerns. Furthermore, federal and state grants for millions of dollars are available for emergency preparedness and disease prevention. Add to that the money that would be saved by eliminating the unnecessary Office of Intercommunity Health and the money municipalities would save by ending their own health inspection efforts, and the creation of a health department may end up saving the taxpayers money.

The Opposition

The Republicans currently in power claim to see nothing wrong with public health conditions in Delaware County. They favor continuing the system that has brought us the high-risk conditions under which we now live. The organization currently responsible for Delaware County's health is the Intercommunity Health Office. Constituting a staff four individuals + who themselves have very limited health-related backgrounds + this office, which relies primarily on the initiative of municipalities, has proven totally incapable of monitoring and managing county-wide health problems. Furthermore, it has neither the adequate plans nor the capacity to implement such plans in cases of emergencies.

Due to the growing chorus of voices demanding change in the system, County Council has commissioned the Drexel University School of Public Health to investigate the county's current level of preparedness with regard to pandemics and other possible health and safety issues. At first, this appears an encouraging step. However, County Council has refused to provide the public with any details about the study. What is the cost? Will Drexel be restricted to a review of the County's current health delivery system or will the study also analyze the viability of a County Health Department? Will the public have access to Drexel's complete, unabridged report? Furthermore, it appears the study will not be completed until after this November's election, depriving voters the opportunity to review the facts fort themselves & make a fully informed decision at the polls.

The truth is that it really does not take a University study to tell us that our system is failing; all it takes is common sense and a look at the facts. This is not a partisan issue. In an editorial dated October 24, 2007, the Delaware County Daily Times became just the latest organization voicing the urgent need for a County Health Department, joining countless other groups and individuals across the County. The lack of action and deliberate stalling tactics employed by the Republican County Council on this issue are baffling; and the only conclusion that can be reached is that our County Council is dangerously unconcerned with the health and safety of the people of Delaware County. They apparently have other priorities.