The Kansas Reflector welcomes opinion pieces from writers who share our goal of widening the conversation about how public policies affect the day-to-day lives of people throughout our state. Vicki Collie-Akers is an associate professor in the Department of Population Health at the University of Kansas School of Medicine, and serves as the Kansas Health Foundation Professor of Public Health Practice-Kansas City.
I recently attended a meeting about the state of public health in Kansas and was stunned to learn that, in the midst of the pandemic, as many as 15 local health department directors have left their positions.
It’s a sobering reality. During a pandemic, in a state with 100 local health departments — including two that represent multiple counties — 15% of them are lacking key leadership or experiencing turnover.
It is also clear that additional roles within local health departments have seen significant turnover. Although it is certainly fair to note that a number of reasons may influence this issue, it is worth citing the attacks leveled at governmental public health employees is likely a leading factor.
As a university faculty member focused on contributing to and strengthening public health practice in Kansas’ local health departments, I have the good fortune of counting staff from several local health departments among my valued colleagues.
This includes one who filed a police report in response to a business owner making a threat to her when discussing compliance with public health orders. Another colleague received a threatening letter at her home. As I share an office at a local health department with a professional recently out of college and new to the public health profession, I can regularly overhear him being berated when he calls restaurants and retail settings in response to complaints filed by community members.
This, as well as other indicators, suggests that Kansas communities and the public health workforce are not immune from the harassment, denigration and threats observed across the country and noted by Michelle Mello and colleagues in recent a Journal of the American Medical Association article.
Unfortunately, the backdrop of a difficult environment comes at a time when local public health workers are needed most. Governmental public health in Kansas, which takes place through local health departments, has been on the precipice of a large-scale reckoning for some time. Prior to this year, state funding for local public health had not increased at all since 1992.
The impact of the state-level preemption for local taxes has reverberated through local public health, which is consistently at the bottom of priorities of local government. Misconceptions about the causes of good health drive this low priority.
Individual-level genetics and health care account for a small portion of a single person’s health, yet the individual-level perspective takes an outsized role in government decision-making and expenditures. Further, the individual-level perspective, unchecked by science and a full understanding of drivers of health, contributes to toxic individuality that endangers the health of us all.
Governmental public health in many communities serves to improve population-level health outcomes, identify opportunities to improve community health and address conditions that make us unhealthy.
A continual disinvestment and devaluation of public health threatens the services and capabilities Kansans and their communities receive. Making screaming at and threatening local public health officials and workers a commonplace or even acceptable activity weakens the already struggling foundations of public health in Kansas.
Several years ago, the American Public Health Association established the “This is Public Health” communication campaign to educate the public about the reach and relevance of public health. The campaign illustrated that public health takes place through the people who inspect swimming pools, administer vaccines and support policies advancing healthy conditions and communities.
At this moment, in the face of a pandemic that has had an impact on all parts of our lives, it is important to understand that public health is a system of people working in local health departments to monitor and investigate disease outbreaks and mobilize resources for addressing the disease and the unmet social needs this crisis has brought to the forefront of our awareness.
At the same time, we need to also recognize that the same people creating and enforcing public health orders, conducting case investigation and making critical decisions for our communities are the people we would, under different circumstances, encounter at school drop-off lines, run into at the grocery store or catch up with in our driveways. For those of us from universities, they are our graduates.
It is critical that we recognize that our neighbors are public health.
Service to community takes many shapes and forms. Public health workers are working tirelessly to serve and support Kansans at this uncertain and difficult time.
If we remember they are our neighbors, then at a minimum we should treat them with the respect, kindness and dignity they deserve. Beyond that, we owe them our sincere thanks and support for all they do on behalf of our communities.
Through its opinion section, the Kansas Reflector works to amplify the voices of people who are affected by public policies or excluded from public debate. For information, including how to submit your own commentary, click here.