Public Health

By Robert Field, professor of law and public health at Drexel University:   Do you know anyone who died of polio or from a cup of water? If you live in America, probably not. But in many countries, such tragedies are still common. We in the United States owe our good fortune to the work of public health. It protects our health and well-being on a national scale. Public health is different from health care. The latter is the range of services we receive from doctors, nurses, and others.

In November 1989, the voters of Montgomery County overwhelmingly voted to create a county health department - 52,734 in favor, 31,646 opposed. Rosellen Burcin was one of the naysayers. Burcin is the local health officer for Lansdale Borough - and far from the only opposition voice among her counterparts. "It's a touchy subject," she says of the long-standing controversy over local health monitoring versus countywide monitoring. "The populace is perceiving that we (health officers)

At a time of growing public-health concerns - bioterrorism, West Nile disease, obesity - programs to develop experts to deal with such problems are sprouting in the Philadelphia region - and across the nation. These new programs train people for jobs in health departments, health systems, drug firms, and community health groups. There are now at least six graduate-level public-health programs in Southeastern Pennsylvania and one in South Jersey. Four have been launched in just the last year.

Delaware County residents would benefit from leadership in and coordination of public health systems, according to a study discussed Wednesday night at a rare nighttime County Council meeting. The study also identified gaps in coverage that indicate room for improvement in such areas as outreach for smoking and alcohol consumption, bicycle helmet use, Lyme disease, and sexually transmitted diseases. About 50 people attended the meeting with the council and researchers. In June 2008, the county contracted with Johns Hopkins University's Bloomberg School of Public Health to survey its public health services and identify needs.

Philadelphia's only school of public health has a new dean. Marla Gold, an infectious disease specialist, stepped into the job this month at Drexel University. She replaces Robert O. Valdez, who resigned to become a professor in Drexel's business school, according to university officials. Gold didn't need to move far to become dean. Her new digs at 1505 Race St. are only a block from her AIDS/HIV clinic on Vine Street, where she and colleagues put together the largest practice of its kind in Philadelphia.

They threw everything but rotten tomatoes at Health Commissioner Maurice C. Clifford when he appeared before City Council late last month. The bad blood might surprise most folks since Dr. Clifford keeps an exceedingly low profile in a city that ranks right up there with the worst in the nation in terms of infant mortality, teen pregnancy and AIDS. In a nutshell, that's part of the problem: Dr. Clifford is a gentlemanly physician who, at 67, gives the impression he's stepping back from the fray, at a time when the city's health problems show no sign of slackening.

Robert M. Patterson, 63, of Center City, a professor of public health at Temple University who researched environmental health hazards, died of pancreatic cancer March 14 at home. During his career, Dr. Patterson was involved in 35 research projects, including setting guidelines for workplace exposure to chemical substances, studying the exposure of commuters to motor-vehicle pollutants, and researching the electrical conductivity of power-line workers' boots. He helped Philadelphia Air Management Services develop asbestos regulation and served on Philadelphia's Air Pollution Control Board.

James McAnaney, 55, of Northeast Philadelphia, an investigator for agencies tracking AIDS and other sexually transmitted diseases who devoted half his life to public health, died Thursday of non-Hodgkins lymphoma at Thomas Jefferson University Hospital. Mr. McAnaney began his career in New York as a U.S. Centers for Disease Control representative in the early 1980s. "He canvassed neighborhoods and knocked on doors in Brooklyn, investigating sexually transmitted diseases," said his wife of 16 years, Suzy Drinan.

For Allison Oler, the severe shortage of influenza vaccine is more than a story on the nightly news. As the mother of three children, she knows that her house will be incapacitated for a week if - or is it when? - the flu arrives. Worse, as a primary-care physician, she has several thousand high-risk patients who are now without an inoculation that could save their lives. Five years ago, there wasn't much interest in the vaccine; now it is more precious than a winning lottery ticket, and its distribution seems just as random.

Philadelphia remains the unhealthiest county in Pennsylvania, according to the latest annual rankings, though it has improved substantially in its rates of smoking, violent crime, and premature death. Chester County ranked as the state's healthiest county, a status that, like Philadelphia's, is strongly linked to social and economic factors. Bucks and Montgomery Counties also made the top 10 in the analysis, commissioned by the Robert Wood Johnson Foundation, and Delaware County slid a few places to 41st out of the 67 counties.

If federal spending cuts kick in as planned Friday, Montgomery County would lose significant funding for seniors, students and job-seekers, Commissioner Josh Shapiro said. In a news conference Thursday, Shapiro outlined how the "the sequester" - a technical term for $85 billion in automatic spending cuts - would affect the county: Seniors - waiting lists for Meals on Wheels and senior centers; reduced funding for senior-abuse investigations; reduced transportation for medical appointments; a waiting list for family caregiver subsidies.

New Jerseyans can breathe a sigh of relief that Gov. Christie on Tuesday joined the growing ranks of Republican governors savvy enough to put aside party loyalty and embrace a key element of Obamacare. Christie's decision to enact an expansion of Medicaid is a move that, as the governor noted in his budget speech, "will provide health insurance to tens of thousands of low-income New Jerseyans, help keep our hospitals financially healthy, and actually save money" for the state's taxpayers.

His coffee consumption level hasn't changed. Nor has his sleep schedule. But Michael McTigue feels a lot more energetic at work these days, perhaps because he stands most of the time. Sitting at a traditional office desk, "I ended up exhausted at the end of the day," said McTigue, director of digital media for pharmaceutical giant GlaxoSmithKline. "There was nothing stimulating me. " About a year ago, Glaxo set up a pilot program in which employees could work at adjustable-height desks, among a slew of other workplace design changes in preparation for the company's move from its Center City offices to the Navy Yard on Monday.

By Patrick Basham and John Luik Tobacco users should be required to obtain a "smoker's license" to buy cigarettes. So argues the academic Simon Chapman in the journal PLOS Medicine. He envisions a "smart card" system that would allow the government to limit smokers' cigarette purchases and encourage them to quit. Licensing is the antitobacco movement's latest proposal to "denormalize" smoking - that is, to portray smoking as unacceptable and smokers as deviants. It confirms that public-health elites suffer from Mary Poppins Syndrome: They won't rest until we're all practically perfect in every way. This kind of paternalism assumes (incorrectly)

When the leader of the nation's largest health philanthrophy looks at the world today, she sees great opportunity and growing challenge. Scientists have more data and can better measure the quality of health treatments, notes Risa Lavizzo-Mourey. But "some of the things we used to look at as gaps" - income disparity and political polarization - "are now more like chasms. " And then there's money. "We are much more cognizant of health-care spending than we've ever been in the time I've been in this," said Lavizzo-Mourey, president and CEO of the Robert Wood Johnson Foundation, which is based in Princeton.

TRENTON - State health officials say a program that allows drug users to swap dirty needles with clean ones to prevent disease transmission has shown continuing success. The Department of Health issued a report Friday recommending continuation of the Syringe Access Program. The report says the program has helped 10,000 residents of Atlantic City, Camden, Newark, Jersey City and Paterson reduce their risk of HIV and hepatitis and gain access to public health and social services.

CAIRO - Egypt's doctors began a partial strike Monday, abstaining from offering nonemergency services in public hospitals to protest run-down facilities and meager wages, the physicians' union said. It is the latest outbreak of labor unrest since the 2011 ouster of Hosni Mubarak. Like workers in other sectors, the doctors say they are demanding remedy for decades of poor funding, neglect, and corruption under the deposed president and his predecessors. Twenty months after an uprising partially fueled by demands for social justice, they say, hospital overcrowding forces sick patients to sleep on the floor.

As of Friday, the Pennsylvania Department of Health reported nine cases of West Nile virus in Pennsylvania residents, including one in Philadelphia, one in Bucks County, and two in Delaware County. Jeff Moran, a spokesman for the Philadelphia Department of Public Health, said the Philadelphia case is a city resident who was diagnosed in Maine and is being treated in a hospital there. The New Jersey Department of Health and Human Services reported four human cases, one each in Hudson, Ocean, Middlesex, and Monmouth Counties.