Victims of success: How do we maintain public health urgency as we stop more outbreaks?

The dilemma and challenge for public health agencies today comes from the diminishing role that infectious diseases play in our daily lives. We are the victims of our own success. Since many infectious diseases that ravaged our children, elderly and medically fragile are much less common, our visibility is reduced compared to yesteryear. We rarely are in the news instituting quarantines, closing down restaurants or implementing mass immunization efforts. The public no longer has a “face” of public health that it can recognize in their daily lives.

Due to immunization efforts and outbreak control, measles is very rare in Idaho; our last case was reported in 2001. TB has decreased from over 200 cases per year in the 1950s to fewer than 20 cases a year today. Diphtheria is almost wiped out. Smallpox is gone. Other infectious diseases, like influenza and pertussis (more commonly known as whooping cough), continue to take a toll, but arouse less public fear.

As a public health official, I know this is great news. But it spurs a bigger question: As our society improves at immunizing against and containing infectious diseases and outbreaks, how does our role change?

For many people, public health means the assurance that someone is monitoring septic systems, immunizing our young and inspecting restaurants. This perception is reasonable: The major accomplishments of public health, still praised today, include clean water, life-saving immunizations and improved food safety. But in the past decades, the focus of public health has expanded to include many other conditions not traditionally within our purview. The challenge facing us today is, with limited resources, how can we maximize our talents and resources to continue improving the public’s health?

The leading causes of death in Idaho are now accidents, cancer and heart disease. There has been a recent striking rise in drug overdose deaths. So why not simply shift our focus to the chronic diseases, injuries and drug poisonings that afflict us today?

We are well aware that these are important issues, and have expanded into these areas. Just in the last year and a half, we have added resources to combat health care-associated infections, initiated a suicide prevention program and obtained funding to combat prescription drug overdose. These changes are significant and will hopefully have an impact on the health of our citizens.

But these are huge challenges that will not be conquered in a month or a year. We will continue to work on them and are committed to improving the day-to-day health problems facing the state. In addition, we are very engaged in the efforts to change the focus of health care from treatment to prevention and quality management of chronic health conditions.

Despite this, we know that the public’s expectation is that we will continue to do everything we can to prevent and control outbreaks of disease as they arise. From the common flu to diseases that could be brought to Idaho by returning travelers, such as Ebola or Zika, we will continue to aggressively search for and neutralize threats to the health of Idahoans.

The challenge of the current time is how to both maintain the ability to prevent and control communicable disease threats and grow our capacity to tackle conditions that require new skills and new approaches. This evolution is difficult but we know we must both expand in new directions, and hold the old communicable disease threats at bay.

Christine Hahn addresses the Boise City Club on Idaho public health issues Thursday, Jan. 26, at an 11:45 a.m. lunch forum at The Grove Hotel in Boise. Registration deadline is noon Tuesday, Jan. 24; visit cityclubofboise. org.

This story was originally published January 23, 2017 at 12:27 PM with the headline "Victims of success: How do we maintain public health urgency as we stop more outbreaks?."