This is Public Health

Former U.S. Surgeon General, C. Everett Koop said, “Health care is vital to all of us some of the time, but public health is vital to all of us all of the time.”

The responsibility of public health is to assure, maintain, protect, promote, and improve the health of the people. However, it is the responsibility of all members of a community to assure the conditions that help keep people healthy ? health behaviors, access to quality medical care, jobs and education, public safety and physical environment. Where we live and work matters to our health. Local public health contributes to the health of a population by providing the public access to an array of health education services.

Currently, in Lake County, the public health department provides adult and child immunizations, communicable disease follow-up and contact investigation, emergency preparedness planning, home visiting for pregnant women and their children, WIC supplemental and nutrition services, tobacco prevention education and family planning services including STD screening. Local public health is responsible for ensuring that the public’s health is safe — not just the health of people in need, but everyone’s health. Nothing happens in isolation; the entire community is affected by health conditions.

The week of April 4-10 is National Public Health Week, a week when public health advocates across the country celebrate the accomplishments of public health. Here in Montana, public health is in jeopardy. At the time of this article’s submission, the Montana State Legislature has removed funding from the state budget for vital public health programs including the Montana Tobacco Use Prevention Program (MTUPP), Title X Family Planning and funding for contraceptives. The loss of these programs has far-reaching effects.

MTUPP provides education to prevent tobacco use among young people, strives to eliminate exposure to secondhand smoke and promotes quitting among adults and young people. This funding also helps to pay for the services of the Montana Quit Line, which provides assistance for Montanans looking to quit using tobacco. This service also offers free nicotine replacement products for up to six weeks, reduced co-pay for Chantix and a free and personalized quit plan.

MTUPP funding also supports the reACT Against Corporate Tobacco Program, which is Montana’s youth empowerment movement which encourages teens to educate their peers about the truth and facts of the tobacco industry. It is important to understand that the funding for MTUPP does not come from taxpayer dollars. Revenue to fund MTUPP comes from the Master Settlement Agreement (MSA). In 2002, 65 percent of Montanans decided in voters’ initiative I-146, that a portion of the money be placed into a tobacco use prevention program. According to a recent Moore Information poll, 80 percent of Montanans still agree with that initiative.

The Lake County Family Planning program is supported by federal funding through Title X. The Title X Public Health Service Act was enacted in 1970 by President Nixon and is the only federal grant program dedicated solely to funding comprehensive family planning and related preventive health services to individuals. The Title X program is designed to provide access to contraceptive and medical supplies and to subsidize services to low-income clients. Information gathered by the Guttmacher Institute in 2006 shows that contraceptive services provided at Title X clinics in Montana helped prevent 5,600 unintended pregnancies, which would likely have resulted in 2,500 unintended births and 2,300 abortions.

Preventive health services offered by Title X clinics include breast and pelvic examinations; breast and cervical cancer screening according to nationally recognized standards of care; sexually transmitted infection (STI) and Human Immunodeficiency Virus (HIV) prevention education, counseling, testing and referral, and pregnancy diagnosis and counseling. In addition, clinics provide patient education and counseling to encourage overall health. Title X clinics also offer community outreach and education.

If Title X funding is not restored to the state budget, many individuals will no longer have access to preventive health care that saves lives and saves our state money. Montana’s investment in services is highly cost-effective. Nationally, family planning saves nearly $4 in public expenditures for every $1 spent.

The approximate savings in Medicaid costs for the prevention of one unintended pregnancy is over $12,000. This savings includes prenatal care, delivery, and the first year of an infant’s medical care.

The loss of funding for these public health services in Lake County also means a loss of jobs. Title X and MTUPP funding help pay for salaries for nurses, health educators, and health promotion specialists. A reduction in staff means a reduction in the capacity for the public health department to safeguard the health of the community. This is not good news as the US Department of Labor and statistics reports the unemployment rate in Lake County is 13.4 percent. When more and more people these days need to be more conscientious consumers of health care, these services are needed more than ever.

Laurie Garrett, author of “Betrayal of Trust: The Collapse of Global Health,” said, “When [public health] is at its best, nothing happens; there are no epidemics, food and water are safe to consume…”

We all need to do our part, however small it may be, to ensure that public health remains at its best.