Gold That Buys Health can Never be Ill Spent

Statement on Westport-Weston Health District Proposal and Proposed Town Budget

Easton faces an important decision about how best to assure the public health of our residents in the years ahead.  The timing of this decision could not be more fitting.  In the wake of the most catastrophic infectious disease outbreak in over a century, it behooves us to give serious attention to the stakes at hand. We can ill afford to get it wrong.

For too long Easton residents have relied on a part-time, understaffed local health department, lacking the capacity to perform many of the essential functions that are now widely recognized as fundamental to protecting and promoting public health in local communities. The proposal before us, to join  the Westport-Weston Health District, provides a viable means to change this reality.  

Health districts are not a new, unproven concept in Connecticut  They have existed for over 50 years, with Westport-Weston on the leading edge as the first towns to establish a district in our state. Connecticut currently has 20 full-time health districts serving a large swarth of the state’s population. These multi-town health departments provide far more comprehensive public health services and protections from emerging threats than would be possible with many small understaffed health departments. The Westport-Weston Health District proposal details the breadth of services and public health protections that Easton stands to gain by joining the district. These details can be easily accessed on the Easton website for all who seek to learn more about the district model and the specifics of the Westport-Weston proposal. Following are just a few of the benefits to Easton from joining a district:

  • A full-time professional staff with diverse expertise, fully trained to conduct the usual regulatory functions that will continue to be important in Easton such as food inspections, and septic system reviews, and also able to perform other critical functions including local disease surveillance and assistance with emerging infectious/communicable disease events to prevent outbreaks altogether and to mitigate outbreaks that occur. These skills and activities are paramount to our management of and recovery from the current pandemic. 
  • Expanded hours and public access to the important regulatory services that the Easton Health Department has traditionally offered to protect our food and water supply and attend to other environmental concerns that can adversely impact public health such as uncontrolled development, as well as more uniform enforcement of state and local public health codes and regulations across Easton, Westport and Weston.  Easton has a particularly salient responsibility to protect the public water supply of hundreds of thousands of residents in our region who draw their water from our reservoirs. Local health departments play a key role in advising on land use and development to prevent potential contamination of this vital resource.
  • A broad range of preventive health screenings and health education programs for residents of all ages and particularly older residents, provided in collaboration with our Easton Senior Center, public library, schools, EMS and others with a role and interest in these activities. Easton is not immune to contemporary health issues faced by other communities; the opioid epidemic and other addictions, mental health problems affecting youth and adults,  domestic violence, tobacco use and now vaping, and eating disorders, and lack of access to affordable health care, are but a few examples. Fully staffed health departments can and do hep to prevent and ameliorate the impact of such health problems and threats.

Some have argued for creating a full-time health department for Easton, capable of providing the essential services, rather than joining a district and potentially compromising our independence and primacy on local public health matters. While there is no question that Easton should invest more heavily in public health, creating a stand alone so called full-time health department in this town is at best an inefficient model.  The cost of funding such a department would be unreasonable for a population the size of Easton. 

Even with a full time health director, a public health nurse, a sanitarian, and a receptionist, which is the minimum staffing scheme for a full-time health department capable of fulfilling basic expectations and mandates of public health departments today, Easton residents would not have access to the range of disease prevention and health protection/regulatory services available from a regionalized health department with pooled resources. Moreover, opportunities to leverage funds through grants would remain limited as small towns cannot usually compete nor qualify for private and public sector grants. We could have more comprehensive and reliable public health services for less by joining a district.

As we continue to struggle to mitigate the spread of COVID-19 and its impact on our health and economy, strong local health departments will play a pivotal role in how we emerge from this experience. The importance of their role cannot be overstated.  Consider some of the critical responsibilities they bear in this situation:

  • Testing, tracing and tracking the spread of COVID-19 to identify and support people that have   been exposed and help them self-quarantine to stop further spread. These old and proven public health interventions are especially relevant in the absence of a vaccine or effective treatments for COVID-19. The State of Connecticut is now in the process of greatly ramping up these services in an effort to stymie the current outbreak as well as reduce the scope and intensity of subsequent outbreaks. This effort will rely heavily on the participation of local health departments. 
  • Supporting the mental health and well being of community members in quarantine to ensure compliance and link them to additional services and supports — like groceries, safe housing, behavioral health services, or child care.
  • Educating and advising the community on ways to prevent exposure and maintain their health and safety .

As we are witnessing,  infectious diseases know no boundaries and the only way to prevent and mitigate such outbreaks is through concerted efforts that involve the collective action of government, the public and the private sector.  A strong public health system is the fulcrum of such action and the best guarantor of good health.

The work of public health often goes unnoticed, with little fanfare until a new threat emerges and the “silent army” is called to the fore.  COVID-19 will not be our last large scale public health crisis nor will the need for strong public health departments recede when this pandemic is history. When the need arises we can ill afford to find ourselves bereft of the unique and invaluable expertise, skill and knowledge that public health professionals bring to any number of complex health problems that threaten communities today.

We have an opportunity to strengthen public health protections for our community at a time when the need could not be more compelling.  While change always brings some risk and uncertainty, I hope that we will choose the high road and remember the sage words of those who lived through times of pestilence and plague, when the science and art of public health was far less sophisticated, yet understood that without health there is nothing.  

“Gold that buys health can never be ill spent.”   17th century writer

“The first wealth is health.”  Ralph Waldo Emerson

Joining a health district with contiguous towns that share similar needs and characteristics is a logical and sound decision for Easton. The time to act is now, while the opportunity is before us, and not for fear of censure from the State for failing to meet mandates but in the interest of optimizing the public health protections and services that our residents deserve in a way that is most impactful and cost-effective.

Elaine O’Keefe is a 25 year Easton resident, recently retired from the Yale School of Public Health, who served in the public health profession for nearly four decades working mostly on the ground in local health departments in the northeast including 14 years as health director of a full-time health department in Connecticut. 

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