Delaware County is the only county of the five in southeastern Pennsylvania that does not have an “established department of health.”
It is not alone, as only six counties of the 67 in the Keystone State that have a public health department. To this six, add four municipal health departments (Allentown, Bethlehem, Wilkes-Barre, and York).
The good news is Delaware County officials have begun the process to establish a full functioning health department whose purpose is to reduce morbidity and mortality through safety and protection measures, provide select health services, and promote healthy lifestyle information and programs.
The rationale to get serious about establishing this public good goes beyond the obvious COVID-19 virus outbreak. It goes beyond those recently elected county officials who claim noblesse oblige to get a department up and running, while shaming the many former commissioners who “failed to act.”
The rationale for a local public health department can be credited to, not surprisingly, the Founding Fathers. Similar to Plato being “the footnote to all Western Philosophy,” the Founders explained the grand experiment to form a more perfect union in our founding documents.
An important section of the Constitution—health and welfare—gives strong authority to the states, and subsequently localities, to protect, preserve, and promote the health, safety, morals, and general welfare of its people—often referred to as the police powers.
A guiding rationale of public health is that those at the local level are in the best position to determine what needs exists for the people. Why risk judgment from Harrisburg or Washington when the local residents and public officials are better situated and acutely aware of public health needs?
While COVID-19 is pandemic in scope, the variability in the intensity of the scourge is uncanny, with a few hotspots, but much of this vast country relatively spared. Local public health department officials can determine the information and services that are efficient and effective for residents.
Additionally, most successful public policy initiatives initially come from local municipalities and counties whose legislators generally bypass partisan politics and get to work on reasonable and responsible public health measures. For example, thwarting youth access to tobacco ordinances, smoke-free places, bans on cell phone use while driving, and a host of safety and environmental protection rules are promulgated at the local level — and often creating angst among interest groups with influence at the state level.
Health status and public health resources reports from reputable sources support the establishment of a fully functioning public health department for Delaware County residents.
Such services will go a long way in improving health outcomes of Delco residents such as average life expectancy, self-reported health conditions, and keeping the ability to engage in daily life activities. Additionally, with a local health department, county residents benefit from more federal and state money and grants.
It is understandable that at a time of economic hardship residents and budget planners are loath to fund additional government initiatives. Some may be concerned with mission creep and fear the health department officials may embolden more of the nanny state.
Those with a “less government the better” posture may be thinking this addition is yet another entitlement for which they may not benefit. This is not true, as public health services coming from a dedicated county department are true public goods with benefits shared by all residents — again as evidenced from the rapid spread of this virus.
The COVID-19 outbreak has brought to the fore the value of public health preparedness and response. Public-health services range from preventing and controlling infectious diseases or ensuring safe food handing and distribution, to individual needs such as maternal and child healthcare or violence-prevention programs, to risk reduction guidance such as barriers for outdoor pools or poison control hotlines.
We are aware now more than ever of the need for quick emergency response to natural and human-caused catastrophes and threats. Public health and safety assurance is best handled, even if initially, at the local level.
Former speaker of the US House of Representatives Tip O’Neill (1977-1987), fashioned the expression that “all politics is local.”
So it goes for effective public health services.
