State Health Department helps protect the public - Albuquerque Journal

State Health Department helps protect the public

Q: There’s a Public Health office right across the street from your office. What do they do, and how does that affect my children?

A: Many Americans think that health care begins and ends in their doctor’s exam room. The office of the New Mexico Department of Health across the street is currently closed for remodeling, but its functions, currently located in the big Health Department building near Carlisle and I-25, make it possible for us to do what we do in our exam rooms in many ways.

For one thing, the Health Department manages virtually all of the vaccines that protect New Mexico children. That doesn’t mean that they give most of the vaccines, but through the universal purchasing program codified last month in Sen. Bill O’Neill’s and Rep. Terry McMillan’s Vaccine Purchasing Act, the state purchases and makes those vaccines available to medical providers throughout the state. It’s one of the reasons we haven’t had a measles outbreak in New Mexico.

Our Health Department (NM DOH) deals with many infectious diseases beyond measles and whooping cough. Care for children and adults with tuberculosis — a disease that brought many sufferers to the state a century ago (and killed Mimi, the heroine of the opera “La Bohème” in Opera Southwest’s luminous recent production). It’s now quite uncommon here and we hope stays that way, and using modern treatments for this ancient disease has become centered at NM DOH, protecting the rest of us.

Although many private medical providers deal with sexually transmitted infections, a large proportion is managed by DOH providers. Unlike tuberculosis, STIs are very common. Like TB, they spread rapidly and can have serious consequences. DOH providers are especially good at knowing the latest information about treating STIs like syphilis, gonorrhea, and chlamydia and AIDS, and in tracking down and treating contacts of those found to be infected.

I interact with DOH in several ways. If I find chlamydia or tuberculosis or pertussis in one of my patients, I call the DOH to get help in recommending medications both for my patients and for those they might have exposed. If I were to see a pattern of unusual disease, I would call them for advice, something I haven’t had to do.

The best local example of this function came in 1993, when Gallup internist Bruce Tempest recognized a pattern of severe and unusual lung disease, called DOH, which brought in the country’s premier public health practitioners from the Centers for Disease Control and Prevention. You know the end of the story — finding the Hantavirus and its vector (the animal or object responsible for its spread), the deer mouse.

The Health Department also requires me to report rare and less common diseases like measles and diarrhea caused by bacteria such as salmonella and shigella. You may recall the 261 cases of severe salmonella diarrhea caused by cantaloupe from a single Indiana farm.

Although there were no cases reported in New Mexico, it was prompt action by other state health departments that identified the “vector,” in this case a round one, and kept the disease from spreading further.

Like most health departments and the CDC, our New Mexico DOH has looked beyond infectious disease to work on other disorders that affect the health of groups of people. For example, NM DOH recently collected evidence showing that southeastern New Mexico had far more emergency room and hospital admissions for asthma than other parts of the state or country.

Although it isn’t entirely clear why the southeast has so much asthma, DOH has been able to give medical providers in that part of the state up-to-date information on how to treat the disease to prevent bad outcomes. Unlike salmonella and tuberculosis, asthma is not susceptible to cure, but there are best practices in preventing it from causing severe trouble.

In the opposite corner of the state, careful epidemiologic work by public health experts showed that pedestrian accidents and fatalities in McKinley County were far above the nation’s norm. Concerted action by health providers and law enforcement in the northwest corner of New Mexico based on those data have resulted in improvement.

As is well-known, it was the country’s public health agencies that finally proved the association of cigarette smoking with lung cancer and other forms of both lung disease and other forms of cancer. This is the kind of epidemiological work that couldn’t have been done in a single medical office. A little more than 51 years ago, Surgeon General Luther Terry, the nation’s top public health physician, published the landmark report, “The Health Consequences of Smoking.” Read about it at surgeongeneral.gov/library/reports/50-years-of-progress. There have indeed been 50 years of progress, with the percentage of the population lighting up down more than 50 percent since 1964 (still too high, 3,900 U.S. kids starting smoking each day).

That’s just a little of what our valued colleagues in public health do. Since it’s National Public Health Week, it’s a good time to look at some of the mostly quiet but vastly important accomplishments of “the people across the street.”

Take a look at nphw.org; the theme of this year’s NPHW is “Healthiest Nation 2030,” aiming big to make the U.S. the world’s safest and healthiest country. In order to get there, support for our public health heroes is vital.

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