Public Health and Medicine:

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What is the relationship between public health and health care in our community?
The answer is “partnership.”
The overall health of our community depends on collaborative efforts between the El Paso County Health Department, which is population focused, and our local health care providers, which is patient focused.
Both public health and medical providers offer programs and services that address health concerns, while helping to sustain quality of life for our residents. They carry out a common mission: To enable people to live their lives to the fullest. But neither can fully accomplish this mission without the other. There are unique, specialized duties and responsibilities that distinguish public health from health care, but also strengthen our partnership to benefit our community.
Medical providers treat individual patients for specific diseases and injuries, along with conducting periodic exams to ensure you and I enjoy continued health. Patients often visit their providers on an as-needed basis. Public health professionals routinely monitor diseases and identify possible public health threats for the entire community in efforts to stop or minimize the impact of those threats.
These programs and services are year-round, and are directed at controlling and preventing infectious diseases and other conditions that ultimately cause substantial illness, hospitalization or death in our population.
For example, public health’s population-based approach to maintaining a well and safe community includes:
• Preventing and controlling diseases and outbreaks, such as whooping cough, hepatitis A and tuberculosis.
• Preventing and controlling the spread of animal-borne diseases that might infect humans, like West Nile virus and rabies.
• Assuring that the food we eat is safe, both at home and at restaurants.
• Making sure that recreational water facilities are safe from disease.
• Monitoring, controlling and treating sexually transmitted diseases, and educating at-risk populations about how to avoid infections.
A timely illustration of the collaborative and specialized roles managed by public health and medical providers is seen with whooping cough (pertussis). The health department has seen a significant increase in whooping cough cases in our community compared to last year—30 cases so far in 2007; 18 cases total in 2006.
Because this disease is easily spread from one person to another and can occur in public settings like schools, it is vitally important that infected individuals are treated quickly. People who have been exposed to the infection need to be identified and tested if they are sick, and everyone involved must take necessary precautions to protect themselves and their families.
Public health can hear about cases of whooping cough from the medical providers or laboratories in El Paso County. Representatives from the health department’s Communicable Disease Program then contact these providers to gather specific clinical data, such as the patient’s exposure history and potential contacts.
While medical staff will treat the individual patient and provide preventive medicine for family members, it is up to the health department to take the lead in further investigating possible exposures, both in and out of the home. Our staff works closely with the medical provider and patient to identify people who might have been exposed and in situations where public agencies or institutions are involved — such as schools and churches — representatives from these organizations are included in the investigation.
Affected individuals are advised by the health department, in person as well as through phone communications or correspondence, and we depend on the community medical providers to work with us to evaluate and test other sick people when necessary. Throughout the investigation, the health department is continuously compiling data about cases and disease spread so that we can keep medical providers up to date on what is going on in our community.
While providers might see a single case of a disease in a year, public health officials might be investigating dozens or even hundreds of cases during the same time span.
These are the unique perspectives and skills that public health brings to monitoring and reporting about infectious diseases in our community. We rely on medical providers to notify us about individual cases and medical providers rely on public health to provide a “big picture” about what is being observed within and outside our county. That is why timely and consistent information exchanges are so important between both disciplines to ensure our citizens are healthy and safe.
The application of epidemiologic methods, monitoring health status, investigating contagious diseases and unusual disease occurrences is the heart of public health in the community.
Rosemary Bakes-Martin is executive director of the El Paso County Department of Health and Environment.