Everett, Wash.

Published: Tuesday, April 8, 2008

GUEST COMMENTARY

Public health: More challenges to meet

By Dr. Gary Goldbaum



I will bet you weren't thinking about public health when you woke up this morning. But guess what? Public health was there when you yawned and filled your lungs with clean air. We were with you when you brushed your teeth, and the wastewater emptied into a septic system we reviewed and approved. If you drove your car to work, you buckled up first. If you biked, you strapped on a helmet. In your workplace restroom, you washed up with hot water and soap, and dried off with a single-use towel that you placed in a trash container for sanitary disposal.

Did you go out to lunch? The people who made and served your meal were trained in safe food handling, and the restaurant or school kitchen was inspected for hygienic practices. On your way home you might hear a radio update about flu season, or perhaps a public service announcement encouraging you to stock an all-hazards emergency kit at home. You experience all of those things day in and day out without thinking twice about public health, but we're with you all the time.

A century ago public health stressed good hygiene to help mothers survive childbirth and to help their babies survive infancy. More recently, public health's vast immunization effort has helped children avoid many serious and (often) fatal communicable diseases. Building on those amazing achievements, today we focus on assuring that parents raise their newborns in environments that allow them to thrive and become productive citizens.

In the early 1900s, a white person in our country could expect to live for 47 years, and a black person could expect to live for 33. The 10 leading causes of death back then were pneumonia and influenza, tuberculosis, heart disease, diarrhea, stroke, nephritis, accidents, cancer, senility and bronchitis. Flash forward 100 years to 2000, and a white American could expect to live 77 years, a black American 71 years. The 10 leading causes of death among residents of Snohomish County in 2004 were heart disease, cancer, injury, chronic lung disease, stroke, Alzheimer's disease, diabetes, influenza and pneumonia, suicide, and chronic liver disease.

It is interesting to note what public health pushed off the old list: communicable diseases. And look what we need to push off next: chronic diseases -- most aided and abetted by tobacco use, inactivity and poor nutrition. Deadly injuries are still a dark part of the picture.

Our work is cut out for us -- both to maintain the good that already is in place, and also to meet the challenges of our current millennium. You have the Snohomish Health District to do that work locally, although we face major fiscal challenges in the very near future. I strongly believe that public health is the best investment in a community's health that a community can make. With your next breath, next sip of water, next bite of food -- please, remember local public health.



Dr. Gary Goldbaum is health officer for the Snohomish Health District.

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