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Lancaster County residents don't just want a county health department — they need one

Intelligencer Journal - 3/29/2021

THE ISSUE

LNP | LancasterOnline reported Tuesday on a Franklin & Marshall College poll that found overwhelming and widespread support last fall among Lancaster County residents for the establishment of a county public health department. Josh Parsons, chairman of the Lancaster County Board of Commissioners, took part in an hourlong, livestreamed interview Wednesday with several LNP | LancasterOnline reporters to discuss the county’s response to the COVID-19 pandemic.

The COVID-19 pandemic has made some realities crystal clear: Equitable access to health care is imperative. The coordination of resources is essential in a health crisis. So, too, is factual, science-based information.

Lancaster County needs a public health department to address those issues and others.

We’re not alone in this belief. Consider the following.

— The Manheim Township Board of Commissioners voted March 8 to unanimously approve a resolution supporting the creation of a county health department and calling on the Lancaster County commissioners to establish it.

As the Manheim Township commissioners point out in an op-ed today, “There are 67 counties in Pennsylvania and of the largest seven, all but Lancaster County and Delaware County have public health departments, and Delaware County is preparing to launch one.”

The Manheim Township commissioners note the difficulties of making health-related decisions during this pandemic without a county health department. They also write of the “nightmarish rollout” of COVID-19 vaccines here, as senior citizens and others “continue to struggle to understand a disjointed system.”

— In a Feb. 28 Sunday LNP | LancasterOnline op-ed, Drs. Thomas Godfrey and Sangeeta Saxena of the public health sciences department at Penn State College of Medicine, argued: “New and reemerging diseases are anticipated to become much more frequent in the future. ... By linking public health expertise with clinical medicine resources, a county health department would be an asset in the future. Otherwise, we will remain at the mercy of what fate has to throw at us.”

— And an F&M scientific survey of more than 2,000 Lancaster County adults found that when the hypothetical cost of such a department was low, it was supported by 98% of independents, 96% of Democrats and 90% of Republicans. Even if such a department cost taxpayers each $50 a year, it was supported by 59% of the respondents. And not just because of COVID-19 — the county’s need to better address lead exposure in children also drew support for a county health department.

In their op-ed today, the Manheim Township commissioners point out that “there is state funding available to help counties establish health departments, and grant funding for continuing operations. Cost should not be the driving factor behind this initiative.”

We wholeheartedly agree.

“Lancaster County residents clearly want a public health department,” wrote Jennifer Meyer, an F&M assistant government and public health professor who was one of the survey’s researchers, in an op-ed Wednesday.

We don’t just want it. We need it.

Cherry-picking data

In his LNP | LancasterOnline interview Wednesday, Commissioner Parsons said he believes the county needs to be guided by proof — data and metrics — of a public health department’s value before it moves to establish one.

But it’s clear to us that any evidence that doesn’t comport with his ideology will be discarded and its sources derided.

We give him full credit for agreeing to a livestreamed interview. We wish more elected officials would follow his lead and not hide from challenging questions.

But we were dismayed by the shots he took at United Way of Lancaster County and the Floyd Institute’s Center for Opinion Research at F&M over its health department poll.

He accused the pollsters of conducting a biased “push poll” that essentially tricked county residents into answering in favor of a health department. And he continued to press this claim on social media, lambasting the F&M survey’s use of hypothetical tax increases that might accompany the creation of a health department to measure respondents’ strength of feeling on the issue.

Stephen Medvic, professor of government at F&M, responded to Parsons on Facebook: “Public policy is about trade-offs,” he wrote, so it was important to ask if respondents would be willing to pay for the benefit of having a health department.

“As in any field, there is technical expertise and knowledge (in social science research),” Medvic wrote. “I simply ask, respectfully, that you try to learn a bit about the techniques involved before disparaging my colleagues’ work as ‘push-polling’ (which, frankly, is an absurd claim).”

It was an absurd claim.

In the Lancaster Chamber’s virtual “State of the County” event on March 22, Parsons cherry-picked data to suggest that Lancaster County fared better in the pandemic than counties with public health departments.

As LNP | LancasterOnline’s Carter Walker reported, Parsons noted accurately that Lancaster County’s hospitalization rate “is lower than four counties with health departments, and only slightly higher than the other two counties with health departments.”

But Parsons incorrectly stated that Lancaster County had the lowest rate of hospitalizations among third-class counties — it had the third-lowest, according to an LNP | LancasterOnline analysis of data collected by the Pennsylvania Department of Health.

And Parsons failed to mention that “the number of COVID-19 cases per 100,000 residents in Lancaster County is worse than any county with a health department, and deaths per 100,000 is second worst.”

In his interview with LNP | LancasterOnline, Parsons also cited a 2020 Robert Wood Johnson Foundation study that showed Lancaster ranked in the top 10 of Pennsylvania’s 67 counties for health outcomes. But he failed to mention that Lancaster County ranked 43rd in the state in clinical care factors and 55th in physical environment factors (which include drinking water violations and air pollution, both of which are public health issues).

Parsons said he thinks that when people talk about the health department issue, they don’t really understand what it means.

We’re certain that Drs. Godrey and Saxena know what it means. And that F&M’s Meyer, a public health expert, does, too.

And, so, too, do the many people who advocated for a public health department in the past, including Dr. Albert Price, a much-admired local pediatrician; Hilda Shirk, former president and CEO of Lancaster Health Center (now Union Community Care); and Randy Gockley, the county’s former director of emergency management.

Chester County

Parsons has made it clear that he views the potential creation of a county public health department as a “conservative who is somewhat skeptical of growing government.”

He has repeatedly pointed to Chester County’s $13 million purchase of questionable COVID-19 antibody tests as an example of a county health department’s ineffectiveness.

As The Philadelphia Inquirer has reported, however, that purchase was encouraged by that county’s administrator and emergency services director — not its health department — and its county health physician actually quit in protest after “officials decided not to alert test-takers to potentially false results.”

According to the Inquirer, that county’s controller since has made it clear that the health department should take the lead in health emergencies.

Clearly, these matters are best left to health experts.

Plain question

At the Chamber’s “State of the County” event, Kevin Ressler, president and CEO of United Way of Lancaster County, noted that this county’s need for a health department goes beyond just infectious disease to issues such as air quality, lead in the county’s aging housing stock and other public health concerns.

Ressler said he believes we need “some nonbiased coordinating entity that allows us to focus on what the community need is.”

To all of this, we’d add that a county public health department could play a critical role in countering misinformation about health crises such as COVID-19.

In last Sunday’s LNP | LancasterOnline, Nicole C. Brambila examined the belief among the county’s Plain community that it had achieved herd immunity to COVID-19, and so many Plain residents here believe it’s no longer necessary to wear masks, practice social distancing or get vaccinated against that disease.

The six infectious disease experts interviewed by Brambila were skeptical that herd immunity had been achieved and said that even if it had, any resulting protection likely wouldn’t endure.

A county health department, staffed by people trained in medicine and public health, could have worked to counter some of the misinformation that circulated in the Plain — and wider — community. And it would bring to the task an understanding of this county that state officials do not have. It also could be working now to encourage COVID-19 vaccination to guard against future outbreaks.

Lancaster County, the sixth-most populous county in Pennsylvania, needs more than just a single “health and medical coordinator.” Public health cannot be left to politicians. And it shouldn’t be sacrificed to a short-sighted approach to governing that prioritizes money over health.

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