Public Health in Our Town

Urgent Needs

Shrinking Resources

Public Health in the News Everyday

S. Boston house of squalor condemned

City gives owners 30 days to clean

SENATE PASSES TRANS FAT BILL

Third Man confirmed dead from Whittier Farms Milk contamination

Public Health = Protection and Prevention

Doctors treat individuals: Public health professionals prevent disease for whole communities:

West Nile, hepatitis, listeria, AIDS, etc Public health officials protect and inspect our food

establishments, keep our indoor air quality safe, well and beach water safe, sewage and septic systems installed correctly

Emergency preparedness/health responders– During extreme weather events, chemical, biological,

radioactive attacks or accidents– Coordinate and administer mass vaccines, antidotes

Public Health=Public Protection

Protect our families from communicable diseases Ensure safe drinking water: private wells and groundwater Responsible for proper sewage and septic installation License and inspect food distribution

– local farms, restaurants, supermarkets, senior centers Investigate consumer complaints

– housing, garbage, food, illegal dumping Ensure water quality in beaches and pools Ensure safe and sanitary summer camps, motels and campgrounds Safe operation of landfills; housing inspections Coordinating Emergency response: public health aspects; chemical

exposures

Public Health Nurses

Prevent, monitor and control communicable infectious diseases (meningitis, flu, hepatitis)

Work with day care centers, nursing homes, medical offices, school nurses and municipal and state authorities to prevent and control outbreaks

Document and report trends: West Nile, SARS, whooping cough, chicken pox, measles

Reach vulnerable, high risk populations including children and the elderly

Restaurant and Food Safety

Restaurant inspections: proper food preparation and storage, food temperatures, pest control, hand washing, clean bathrooms

Legal requirement to inspect all food establishments between 2 and 4 times per year

Milk and dairy inspections Chemical and microbial contaminants Other food handling: wholesale distributors,

bakeries, summer camp kitchens

MA General Law Title 5: Septic Responsibilities and Liabilities

Today’s septic plans and installations are much more complex than they were in earlier eras

More training and computer skills are now required to review and approve plans

Fallout of an improperly installed or inspected septic system is polluted groundwater and drinking water

Presents a huge liability for towns DEP budget cuts over the last 2 years mean the

entire municipal protection system has minimal support/oversight for septic issues

A New Mandate: Post 9-11 Emergency Preparedness

Officials have adopted an “all hazards” approach to prepare for chemical, biological, radiological incidents

Public health and Public safety agencies all work together: EMTs, Police, Fire and Medical personnel all receive training on same equipment

Coordinate local emergency plans: shelter, telephone call in lines, mass immunizations

Emergency Preparedness:Localized responses and solutions

Plymouth and Franklin counties and northeastern MA are close to nuclear reactors

-potassium iodine tablet distribution

Berkshire County--coordinates efforts in many towns with limited resources

Cambridge- coordinates 27 cities and towns with training and drills

Boston- the largest city and port in NE; a potential target

A variety of new mandates arrive annually…

Beaver removal permits

Sharps Collection and Disposal

Mercury risks and safe disposal

Body arts, tanning saloninspections

PROPOSED PEAK POWER PLANT, CHELSEA MA

Environmental Example: ChelseaEnvironmental Example: Chelsea

Issue: a new peak energy facility plant proposedIssue: a new peak energy facility plant proposed

In May of 2007 examined pediatric asthma prevalence from four elementary In May of 2007 examined pediatric asthma prevalence from four elementary schools (complex of 1,800 students) located ¼ mile from the proposed siteschools (complex of 1,800 students) located ¼ mile from the proposed site

3 out of 4 schools at the complex had pediatric asthma rates statistically 3 out of 4 schools at the complex had pediatric asthma rates statistically significantly higher than the statewide ratesignificantly higher than the statewide rate

MDPH/BEH evaluated proponents estimate of impacts on community for facility MDPH/BEH evaluated proponents estimate of impacts on community for facility related emissions and recommended a number of additional analyses to better related emissions and recommended a number of additional analyses to better characterize potential impactcharacterize potential impact

MDPH/BEH also recommended that various mitigation efforts to reduce the MDPH/BEH also recommended that various mitigation efforts to reduce the proposed impacts should be considered once the more refined impact proposed impacts should be considered once the more refined impact estimates were createdestimates were created

In Nov 2007, the proponent withdrew proposed facility at this locationIn Nov 2007, the proponent withdrew proposed facility at this location

Ever Increasing Mandates:Flat Lined Staffing Levels

Many municipalities are seeing over 100% increases in septic plan reviews

Number of food establishments has exploded in last 5 years Many municipalities operate with volunteer Boards who do

inspections on their own time Housing violations are very time consuming. Extreme

hoarding, a mental illness, creates gruesome dangers for neighbors and emergency responders and is on the rise

Emergency preparedness: the straw that broke the camels back: must coordinate drills with other agencies and towns

Board members so busy doing inspections they can’t focus on policy making such as requiring well testing, disease reporting

State Auditor Joe DeNucci’s Report On DPH Food Protection Program: An Increasing Risk

Highly decentralized system of food inspections is very inefficient and must be modernized.

Must add sufficient state and local staff to oversee and conduct the required inspections. This is an essential step toward improving food safety in Massachusetts.

11 of 13 local authorities visited were not in compliance with federal and state standards that call for inspections at least every six months for most food establishments, and three to four times a year for high-risk establishments, such as large restaurants, hospitals and nursing homes. “ March 2007

FURTHER AUDIT FINDINGS:

Local health authority food inspection activities are significantly understaffed in most municipalities.

In many instances, staffing levels are at least a third less than the federally-recommended levels.

Only 8 percent of inspectors meet the preferred Certified Food Safety Professional qualifications standard

The state program’s inspections of wholesale firms were also found to be inadequate, as more than 2,000 of these businesses were inspected an average of only once every four years.

Public health and town budgets

While responsibilities and mandates have increased local and state public health budgets are holding flat or decreasing

Budgets are being cut an average of 10% across the board Resources are already below what is needed to be to keep up

with current mandates Can’t keep up with inspections that help prevent disease and

stem financial and other consequences: these are liabilities waiting to happen

US FDA guidelines state that each inspector can only perform 250 food inspections per year (that’s 125 establishments X 2)

What if a town has more than 125 establishments? Resources and needs vary: pool inspections take 3 hours; a

water park can take 2 days

Public Health Budget

Local Public Health budget statistics MA State Budget devoted to Health Care and Public Health

All Line Items for Category 'Health Care',SubCategory 'Public Health'From Fiscal Year 2001 Through Fiscal Year 2010

0.000

100.000

200.000

300.000400.000

500.000

600.000

700.000

800.000

FY01FY02

FY03FY04

FY05FY06

FY07FY08

FY09 Curre

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FY10 House

1

Mill

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9 D

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Real (Government)

Municipal Liability

Towns are left open to potentially catastrophic liabilities if they are not able to keep up with mandatory inspections:

EXAMPLES: Need the facts on these cases– Ludlow food handler who died from hepatitis– Indoor air quality at Peabody High– Hepatitis A in Arlington

Restaurants, county fairs, camps all pose potential hazards

The costs of dealing with an outbreak to a community are far greater than the costs of surveillance to prevent one

Public Health= Smart Investment

Prevents outbreaks of disease, food poisoning, cancers, other diseases and deaths

Reduces liability for cities and towns Increases life span by promoting healthy behaviors Identifies trends early to develop response and

controls Efficient public health assessment and response in

emergencies

Every day we deal with bacteria, viruses, environmental contamination,

molds, vermin, and drinking water hazards. And we do it with a smile.

Unsafe housing, tattoo artists, flu pandemic preparedness, illegal dumping, and rabid animal response. It’s all in a day’s work.

We work to keep our community safe from disease and health hazards. The more resources we have, the better

equipped we are to protect everyone’s quality of life.

Public health is often taken for granted: an essential service like public safety that merits strong support.