Your health has been my focus for more than 10 years. While you may not make an appointment to see me in an office like you do with your primary care provider, preventing disease and protecting you and your loved ones from outbreaks is a job I take very seriously.
As I inch closer to my retirement this spring, I’ve found myself reflecting on the richness of my career in public health, especially the most recent decade.
I’ve been a doctor for nearly 40 years. During that time, I’ve practiced medicine in rural and urban settings, as a family doctor caring for all ages and illnesses, and as physician focused on AIDS. Since specializing in public health in 1984, I’ve served at all levels of government — at the Centers for Disease Control and Prevention, the Washington State Department of Social and Health Services, and public health agencies in Thurston, Skagit, King and Snohomish counties. Each of these experiences has proven how valuable public health is, working hard behind the scenes and largely unnoticed.
Public health actions typically influence your health far more than medical care. Few of us spend much time in a doctor’s office or a hospital, but we all live in a world that carries constant risks of infection or trauma, or that can lead us to behaviors that may harm us.
When we drink water from our faucet, we don’t worry about dying of cholera. When we dine at a restaurant, we rarely think about kidney failure due to E. coli. When the person next to us coughs, tuberculosis is the last thing to cross our minds. The air in public places is free of cigarette smoke. Motor vehicle deaths have declined dramatically over the past century, as our vehicles and highways have become safer. These are public health successes.
Yet most of these achievements are taken for granted because public health activities are largely invisible. Despite budget and staffing cuts — more than 40 percent since the recession of 2008 — I’ve been impressed again and again by the extraordinary work of the health district’s staff. They have spent countless hours working to protect and support public health.
Those who work at the Health District ensure that restaurants are inspected, infectious diseases are investigated and transmission prevented, new mothers have access to parenting support, and our community is prepared to respond to emergencies like pandemic influenza. They help keep public places smoke-free and vapor-free, and they foster community-based programs to reduce suicide, promote healthy eating and encourage physical activity.
A striking example was the H1N1 influenza pandemic in 2009 that threatened to cause widespread death and disability. Although it ultimately proved less severe than predicted, it created a very real alarm that posed a serious global challenge. In a remarkable six months, scientists developed a vaccine and manufacturers geared up to produce it.
But how would we get the vaccine quickly to those at highest risk, given that there would not be enough for everyone initially? Thanks to the strong relationships we have between the medical community and public health, we were able to create a plan drawing on the strengths of each sector. Public health provided logistical support, such as distributing the vaccine and coordinating communications, while the medical community staffed mass vaccination clinics around the county.
Over three separate days, this collective effort vaccinated nearly 26,000 people at highest risk, to my knowledge more than any other Washington county managed over the same interval. Everyone who supported the effort — doctors, nurses, paramedics, law enforcement officers, clerks, volunteers — came away exhausted, but feeling rewarded for doing something truly worthy. I was, and still am, proud to have been a part of this.
There have been many more examples like this over my last decade here, examples reminding us that protecting and promoting the public’s health is a shared responsibility. I am proud to have worked side by side with extraordinary community partners and employees who are doing their part to improve health.
There are certainly more issues to be tackled — like the rising rates of substance abuse, sexually transmitted infections, and suicide, and the need to get our children off to the healthiest starts possible, just to name a few. However, you are fortunate to live in a place where collective action is very real. You are also fortunate to have the entire team at the Snohomish Health District carrying on this work. Your health will be their focus … for many years to come.
Dr. Gary Goldbaum is the health officer and director of the Snohomish Health District.
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