An Interview with the Board of Health’s Newly-Hired Public Health Consultant
The Lehigh Valley Board of Health is moving forward with the plan to establish a bi-county health department, and the Board recently hired Gerald Barron of University of Pittsburgh’s Center for Public Health Practice as the public health consultant. Barron, who has over 35 years of experience in the public health field, will assist the Board in drafting the operating budget and staffing and services plan for the Lehigh Valley Health Department. I caught up with Gerry today by phone and asked him about his views on public health and the effort to establish Pennsylvania’s first bi-county health department.
What sort of opportunities can you identify at this time within the Lehigh Valley that will matter for the establishment of the bi-county health department?
A regional health department makes sense, because public health doesn’t stop at municipal lines. Having just the city health bureaus and the county offices doesn’t make as much sense as having a bi-county health department. The regional department will bring in more resources because the two counties – Lehigh and Northampton – are working together. Because of the way Act 315 [Pa. law that allocates funding to county and municipal health departments] works, the bigger the population, the easier it is to receive funding, because the money is allocated per capita. The more people in the community, the more money and subsidies the region will receive from the state. And there are a number of regional initiatives in the Lehigh Valley already. The region really looks at itself as one unit.
You have worked with a number of other county health departments in Pennsylvania, notably Allegheny County. What sort of lessons can the Lehigh Valley take away both in the effort to establish a public health department and, subsequently, in maintaining the department?
One thing that strikes me is that a local public health department needs the involvement of the community. Otherwise, it’s out there alone, trying to make the case for itself, even though the types of services and the extent of services are community issues. In previous experiences, I noticed that the community needed to be involved, that the community needed to be an integral part of the effort. A local public health department cannot be successful without community involvement.
What do you see as the biggest challenge in establishing a regional health department in the Lehigh Valley?
It’s always about the funding – concerns about funding, questions over how the department is going to be funded without overtaxing the people. And the answer again is community support, bringing together the various public health services that are already in this area, in the community, like the Allentown and Bethlehem health bureaus, and the smaller county and municipal offices. It will be important to have the hospitals involved, and have all of the local services work together.
Many studies have linked community design to public health issues. How do you view the relation between the way land is planned (as in, creating walkable communities) and a community’s public health?
This is a critical piece. A big part of public health is the relation to schools, transportation, and a number of things – including zoning and land-use planning. When I give presentations about public health, I talk about all these issues, and audience members often ask “What do transportation and zoning have to do with public health?” And it’s because these issues affect quality of life and have an effect on public health. The design of an environment can make it more conducive to exercising, for example. A public health agency tries to coordinate all the activities and planning that promotes public health. Right now, some of these activities might be happening here in the region but they might not be as efficient or effective because there is no public health department that is coordinating them. I think someone from the public health department should sit in on zoning boards, planning, and economic development meetings. Public health must take a leadership role in this. Development is great, but it should provide maximum benefits for a better quality of life of the public. And having the public health department involved in community planning does not add any costs to a project, because any changes to design are least expensive when done at the planning level.
How do you think the debate over national healthcare reform will have an effect on the discussions about public health and the effort to establish a regional health department here in the Lehigh Valley?
There have been lots of discussions about the U.S. healthcare system moving more toward prevention, since, right now, it’s a sick care system. Public health is all about prevention, and the public health mission in the healthcare reform discussion is about promoting health and preventing sickness, as opposed to treating sick people. I tell my students “If I was sick, I would want to be in the US, but if I wanted to stay well, there are other countries where that [prevention and public health] is done better.” The US spends the most amount of money on health care than any other country, but the funding for public health and prevention programs is so low, around 2%. That needs to be changed. In the Lehigh Valley, the discussion needs to be about prevention, because everyone is supportive of promoting wellness and preventing illness when talking about healthcare. It is important to tie this into the process of creating the regional health department. We can’t lose sight of promoting and improving overall public health in the Lehigh Valley. Public health touches every person, not just those who don’t have access to quality healthcare.
To learn more about the effort to establish a regional health department, visit RenewLV’s Regional Health Initiative page.