What does Northeast Tri County Health District Do?

A healthier community requires more than medical care. It requires protection from dangers that can threaten the health of the entire population. It requires good information about the nature, magnitude and causes of health problems. It requires education about what individuals and the community can do to reduce health risks. A healthy community assures an environment in which its residents can safely work and play. It is Northeast Tri County Health District's job to help build a healthy community.

The Birth of Northeast Tri County Health District

Every county in the state of Washington is required to provide public health protection for its residents. Until the mid 1970's, Ferry, Pend Oreille and Stevens Counties were served by separate health departments in each county. Changes in state and federal law presented challenges to these small health departments that could have meant more dependence on state government rather than having a health department under local control. The need to create an effective and more efficient local system to provide public health protection became apparent.

Local government, working with the local health officers, Ed Gray, MD, for Ferry and Stevens Counties and Bob Morrow, MD, Pend Oreille County, recognized these needs. Negotiations were started with the three counties in Northeast Washington and DSHS, the state public health agency at that time. At the end of 1976, a consensus was reached: Ferry, Pend Oreille and Stevens counties along with all the cities and towns would enter into a health district to provide public health protection for their residents. This health district would facilitate an efficient use of resources while retaining local control.

In January, 1977, Northeast Tri County Health District was born. At that time, there were about 38,000 residents in the combined three county area.

In 1997, with a one third increase in population (approx. 57,000) and with increasing demands and complex issues, Northeast Tri County Health District's job has become more involved and technical. A lot of time is spent bringing public health services to the residents of the District. Still very rural, over two thirds of the population live outside incorporated areas. The District makes services available on a regular basis at 16 sites throughout the three counties. There are 54 employees of the District and an office in each county. The Health District is under the direction of a nine member Board of Health. The Board sets the policies and budget of the District. Each member of the Board is an elected official from the counties, cities or towns they serve. Meetings are held on a rotating basis in each of the three counties.

Most of the activities of Public Health fall into one or more of the following categories:

• PREVENTION
• PROTECTION
• PROMOTION
• SERVICE

PREVENTION: Public health measures may keep a problem from developing in the first place. An example of this is a recent Pertussis (Whooping Cough) epidemic, which struck North Idaho and some counties in Eastern Washington. Northeast Tri County Health District works with area health care providers to immunize children and infants as one of its main priorities. Health officials believe this is the reason why the epidemic did not spread in any great numbers to our three counties.

Northeast Tri County Health District, in cooperation with the Washington State Department of Health, supplies vaccines to all area health providers on a continuing basis.

Recently, a potential Hepatitis A outbreak in a community in the Health District was limited to one family when a special immunization program of school children was undertaken in that area. The District worked with the state to provide these special immunizations. As a result, only two recent cases of the disease were identified and treated. Without immunization, the recent outbreak could have spread to more individuals.

In another example, flu shot clinics are conducted in the early autumn months every year to prevent productive days lost to illness.

PROTECTION: Northeast Tri County Health District's Environmental Health Division investigates conditions that may endanger the public. These conditions could involve water quality, food sanitation, solid waste disposal and septic systems, to name a few. An Environmental Health Specialist inspects local restaurants and snack bars to make sure they are complying with safe food sanitation practices.

During the spring floods of 1997 in Pend Oreille County, Environmental Health played an active role in monitoring the quality of drinking water in all the affected areas. They also kept a close watch on septic systems to avoid potential problems.

PROMOTION: Northeast Tri County Health District offers health education and fosters healthy lifestyles in the community. Recognizing the harmful effects of secondhand tobacco smoke, Northeast Tri County Health District has produced and distributed a brochure identifying local smoke-free restaurants and eating-places. It has also produced "Health Status 1995," a publication which includes health statistics about the tri-county area. The information provides a baseline which enables the community to judge whether their health is improving or declining.

SERVICE: Northeast Tri County Health District collects and reviews all birth and death records filed in the area. The District provides local access to people who need copies of birth certificates for those born in Washington State after 1954. This is done through an electronic connection with the Washington State Department of Health. Copies of death certificates are also available as a service to families.

Northeast Tri County Health District's Community Health Division is responsible for the investigation of, treatment for, and immunization against communicable diseases. Tri county residents with Sexually Transmitted Diseases (STDs) are screened, treated and contacts are investigated. Individuals with evidence of Tuberculosis (TB) are monitored. HIV/AIDS testing and counseling are available.

Family planning services are furnished on a sliding fee scale, as are most of the community health clinical services. A "sliding fee" is one that is based on client's current income.

Another service of Northeast Tri County Health District's Community Health Division is home visits by Public Health Nurses and Community Health Workers. They make home visits to help new moms and dads learn parenting skills, to promote breastfeeding and to ensure that age-appropriate developmental evaluation is available as needed. Health educators and staff make presentations on various community health issues in schools, at health fairs and community organizations.

What About the Bigger Picture of Public Health?

Public Health is mostly a local activity. But health problems can be regional or statewide. When local health jurisdictions in Washington state operated independently, most did not have the ability to maximize their public health resources. In 1993, legislation was passed to change the way Public Health does business. The "Public Health Improvement Plan" is a framework that enables public health systems and community health partners to work together toward specific community health goals. The Public Health Improvement Plan encourages sharing what works and what doesn't, learning from each other and sharing resources. Today, communities are working together to improve the health status of the community.

YOU are the "Public" in Public Health