‘What’s that got to do with the health department?’

It’s the time of year to catch up with distant relatives and family-friends, and I’ve often found myself explaining what it is that health departments even do. The answer can be hard to distill into something short, sweet, and easy-to-digest over Thanksgiving dinner, so I’ve written up the explanation I’d like to give, which may also clear up some questions about why a health department employee is helping with a column on economic development and workforce issues.

Public health — what we do at the health department — focuses on two things: learning what causes people to be healthy or unhealthy, and using that information to keep healthy people healthy and get unwell people the help they need. This sounds pretty straight-forward; isn’t it what all doctors, nurses, and therapists do? Well … sort of.

Your family doctor or local surgeon addresses health at the individual patient level. Let’s take an imaginary Maysvillian, Nolan, as an example. If Nolan runs a stop-sign, hits another car, and breaks his leg, he is fortunate that there will be a host of medical professionals to help him — from EMTs and paramedics in the short term, to occupational therapists in the long term, and doctors and nurses all along the way. Each of them is focused on helping him recover and regain the best quality of life possible.

Public health workers are equally focused on quality of life, but they do so while looking at the public as a whole. They research what makes people healthy or unhealthy, injured or uninjured, able-bodied or disabled, and then develop strategies on how to keep communities as healthy as possible for as much of their lives as possible. We at the health department prevent disease and injury by promoting healthy behaviors (providing nutrition counseling and breastfeeding classes, promoting and giving vaccines, offering free exercise classes, and educating the community about hand-washing, not smoking, etc.) and reducing risk (keeping air and water clean, inspecting restaurants, installing car-seats, enforcing OSHA regulations, etc.).

In Nolan’s case, the public health focus would be on what caused his car-crash and how we can prevent such an injury from happening again in the future. We may learn that Nolan didn’t see the stop-sign. If this is a trend at this intersection, public health workers might then petition the local government for a stop-light or better signage. Or we may learn that Nolan has poor vision but doesn’t wear glasses because he can’t afford them. Public health workers might then prioritize creating and publicizing a list of local nonprofits, government grants, and other programs that can help, so that others in Nolan’s situation know what to do.

Public health workers spend a lot of time focusing on social issues as well. For example, perhaps Nolan didn’t see the stop-sign because he was drowsy from staying up late working a second or third job. Public health workers might then advocate for raising the minimum wage or providing more adult education in the community so that Nolan can earn a living wage without sacrificing six to eight hours of sleep.

Or, perhaps what you’re all thinking is that maybe Nolan saw the stop-sign and just ignored it because he is reckless, irresponsible, or thinks he is more important than others. Public health hasn’t created a perfect solution or vaccine for being a jerk, but there are still things we can do in this situation. We can try to help him build connections through volunteer groups or clubs so he feels more a part of his community. We can collaborate with schools to offer programming that teaches children about empathy and how their actions affect others so maybe they’ll grow up to be more considerate people. And, we can work with mothers and caregivers on early childhood development, making sure to teach them how to raise a baby or child to be a compassionate member of our society so that in 16 years they might be a better driver.

In short, public health is all about understanding the effects that our social, financial, and environmental circumstances have on our health, and then working to make everyone healthier. If this seems broad, that’s because it is. Many people touch on public health in their daily work, from our health department clinic nurses to the YMCA employees to police officers to school-teachers to HR managers. This Thanksgiving, I am thankful for all the public health workers who gave me — and you — the best chance at a long, healthy life.

Ellen Cartmell

Public Health Policy Advocate

Buffalo Trace District Health Department

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