Editor’s note: The following letter was sent back in March when the Village of Oak Park was considering budget cuts. We’re printing it now, as the village prepares to start work on its 2010 budget in September.

For his column of March 18, Dan Haley interviewed supporters of continued funding for the Oak Park Public Health Department and two members of the Oak Park village board, who expressed skepticism about the merits of the health department, relative to other village-supported services like our police and fire departments. [As village eyes more cuts, fierce advocates up the ante, Dan Haley, March 18] To help inform these discussions, I’d like to describe the functions of local health departments:

1. Establishing standards, followed by public and private entities, for procedures that affect the health of individuals or populations

2. Monitoring and enforcing adherence to these standards

3. Performing surveillance for “sentinel events” suggesting an unusually high level of risk to the public heath

4. After detecting and confirming such events, intervening to mitigate this risk

5. Providing services to individuals with conditions to which the public health is most sensitive

The first two are most important; the rarity of news items involving the health department speaks for its effectiveness. Also, declining compliance with public-health standards generally follows whenever effective monitoring and enforcement are withdrawn.

The Oak Park Health Department’s most important activities include:

1. Inspection of restaurants and other public facilities – each of the more than 250 such venues in our village are inspected more than four times annually, according to the interim director, Margaret Provost-Fyfe.

2. Nursing home, assisted living facility, adult and child daycare center inspection – the health department inspects each at least annually and responds to complaints and problems.

3. Response to emerging communicable disease threats – the health department works with its county and state counterparts to provide surveillance for and respond to such threats as meningococcal meningitis or whooping cough in our school-age children, or influenza or diarrheal disease in our elders.

4. West Nile virus surveillance and prevention.

5. Testing and treatment for HIV and other sexually transmitted infections – the health department makes available a free, weekly clinic at PCC Wellness.

6. Case management for indigent families with children, and home visits for infants discharged from high-risk nurseries – more than 300 families received these services in 2008.

Although some of the health department’s functions would be assumed by state or county agencies if it were to be dissolved, others, most notably restaurant inspections, are not available from other jurisdictions at present. Also, similar to the effectiveness of physicians who are familiar with the medical histories and preferences of their patients, local public health authorities generally know their territory better, enjoy better relationships with the communities they serve, and are often more rapid and effective in responding to problems when they arise.

Finally, we should be mindful of how the risks of diminished public health activities extend beyond the health of those individuals who might become sickened as a consequence. The costs of managing epidemic illness are considerable, as are the financial burdens to any businesses that might be involved. For communities, as with individuals, an ounce of prevention is worth a pound of cure.

David Schwartz is an Oak Park resident and infectious-disease physician who has worked at John H. Stroger Jr. Hospital of Cook County for the past 16 years.

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