Greater expectations: What the nation seeks from public health

The nation's public health system is being asked to do more with less, and some fear the breaking point can't be far off.

By Susan J. Landers, AMNews staff. Jan. 7, 2002.

Public Health: Renewed Attention
A six-part series exploring the role of the public health system in the context of our nation's newfound state of alert.

1. From the front lines
2. Recent history
3. Greater expectations
4. The risk-benefit ratio
5. New promises
6. Homeland security

Washington -- How did the nation's public health system, a system already struggling to cope with the myriad tasks now in its charge, cope with the recent anthrax outbreak that swept the nation?

"We managed by putting less urgent -- but not less important -- matters on the back burner," said Elaine O'Keefe, health director for Stratford, Conn., a town of about 45,000. "You take your long-term strategic plan and you throw it out the window for a while. You just focus on the immediate," she explained.

The response in Stratford may have assumed more urgency when an actual case of anthrax occurred in Oxford, a small town just north of O'Keefe's jurisdiction. There, a 94-year-old woman died from inhaling anthrax spores that may have adhered to her mail as it crossed paths with another anthrax-laden letter.

Yet on the other side of the nation, with no anthrax cases reported within thousands of miles, a similar scenario was playing out.

Patrick Libbey, who heads the Thurston County, Wash., (population 200,000) health department and is also the president of the National Assn. of County and City Health Officials, estimates that his department spent an additional $19,500 dealing with the anthrax scare.

The funds were used to ensure that there was a unified community response to the public health threat by law enforcement and health officials and to determine which suspicious packages and letters were to be sent to the state lab for testing.

"We received a fair number of calls from people concerned about their mail," Libbey said. [...]