King County budget crisis puts public health services in peril

In 1954, a cholera epidemic struck London, England. Thousands of people were dying and no one could determine the cause. Doctors were stumped as deathly ill adults and children filed into the overcrowded hospitals.

  • BY Wire Service
  • Tuesday, August 5, 2008 1:48pm
  • Opinion

In 1954, a cholera epidemic struck London, England. Thousands of people were dying and no one could determine the cause. Doctors were stumped as deathly ill adults and children filed into the overcrowded hospitals.

A prominent physician, John Snow, had a hunch that the cholera outbreak was caused by a stretch of contaminated water along the Thames River.

To test his theory, he reviewed where people were contracting the disease and interviewed their families to find out what their water source was. Finding nearly 500 cases within a few blocks, all drawing water from the same pump, confirmed his suspicions that contaminated water was the source of disease. Once the pump was closed, the incidence of disease was drastically reduced, preventing thousands more from dying of the disease. This discovery and pump closure has been hailed as one of the first public health interventions of the modern era.

Since then, public health has been responsible for advances that have resulted in our life expectancy increasing from 38 years in 1850 to 77 years in 2007, and saved millions of lives. Some of the major advancements in the 20th century were vaccinations, food and water sanitation, seatbelt use, control of infectious disease, anti-smoking campaigns, “back to sleep” SIDS education and fewer deaths from heart disease and stroke.

Our Seattle-King County Public Health Department carries on the good work of the last 100 years and continues to identify ways to improve health by:

• Tracking diseases, such as West Nile virus and tuberculosis.

• Creating and promoting anti-smoking campaigns.

• Preparing our region’s healthcare system for emergencies, such as earthquakes and pandemic flu.

• Inspecting restaurants to ensure that the food they serve is safe to eat and employees use sanitary practices

• Collecting and providing disease prevalence data to doctors and nurses.

• Cleaning up meth labs.

• Working with businesses to ensure foods like salmonella-tainted tomatoes are removed from grocery stores and restaurants.

• Conducting autopsies for criminal investigations.

• Running jail health services for inmates.

• Partnering with businesses and community groups to promote diabetes and heart disease management, healthy eating and exercise.

• Ensuring that our drinking water is safe.

But many of these services are in peril, due to the King County budget crisis. The county will cut nearly 10 percent of its general fund next year, according to the county executive’s budget staff. This means cuts to criminal justice, health and human services.

Many public health functions are heavily dependent on the general fund. Programs most at risk for cuts include medical examiner functions, the public health laboratory, where communicable diseases are sent for identification, rodent control, immunization services, tuberculosis control, the Children’s Health Initiative, which connects low income children to state and federal health insurance programs, and maternal healthcare.

Over the course of the next two months, King County Health Board members first will develop a set of guiding principles and values which we will use to gauge the cuts that must be taken. Second, board members will compel the Legislature to develop a plan creating a long-term and dependable funding source that will sustain public health into the future. Otherwise, lawmakers are faced with making cuts that will result in an unstable public health system, and in turn a less healthy community.

Julia Patterson is a Metropolitan King County Council member and chairwoman of the county’s Health Board.


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