Foundational services in a metro health department Patty Hayes, Director Adapted from

Foundational public health services Vital Records Assurance Role: Access to Clinical Care Maternal Child Family Health Environ-mental Public Health Chronic Disease Control & Injury Prevention Communi-cable Disease Control Across all programs: Assessment (surveillance and epidemiology) Emergency preparedness and response (all hazards) Communications Policy development and support Community partnership development Business competencies MEO EMS Jail Health [CLICK THROUGH ANIMATIONS:] These are the health services that every resident of our state should expect to receive, whether you live in King County or Wahkiakum County. The services in the blue box are those that cut across our entire department and make the other services possible. Our metro health department provides additional services that aren’t provided in every county.

Comparing Workforce Costs With Available Funding: 2008-2016

Public health in the metro environment is about size… Population 2 million… and 41% of WA’s population growth Image: Rob Schill, Noun Project

…And it’s about complexity 39 municipal governments 39 police jurisdictions 20 school districts 29 fire districts/departments 39 emergency management agencies 41 water and sewer districts

complexity: healthcare hub Median # of hospitals/county in WA: King County adds: plus the only Level 1 trauma center in the region

We’re a little different. Emergency Medical Services – 50K calls for advanced life support in 2014 Medical Examiner – investigated over 2,200 deaths in 2013 Jail Health – almost 460K patient services provided (2014)

It’s a Diverse place to work! 170 languages 1 in 4 speaks a language other than English at home

We’re an International hub Disease Travels Too 55% of state’s active tuberculosis cases (2013) 236 travelers monitored from Ebola-affected countries (2015) 13 measles cases (2014)

What that means to public health: OUTBREAK POTENTIAL There’s A lot going on Over 100 festivals 158 professional sporting events 192 cruise ships 12K+ restaurants 1300+ foodborne illnesses investigated in 2014 What that means to public health: OUTBREAK POTENTIAL

In a major media market 12th largest media market Over 100 ethnic media outlets 3 million website views/year Image: Gregor Črešnar, Noun Project

Cost of living Median price for a single family home: $500K. Cost of living is 43% higher than U.S. average.

Health inequities 10-year difference in life expectancy between Auburn and Mercer Island More than 8,000 people experiencing homelessness 50% are families with children

Burden of disease Percent of state’s cases (2013): 56% HIV 61% Syphilis 40% Gonorrhea 100% Measles

Safety net 10 public health centers Over 100K people served: Primary care Parent/child health Dental HIV/STD Healthcare for the homeless

Violence prevention in King County 130 deaths annually from gun violence 70% of gun deaths are suicides 39,000 children live in homes with unlocked firearms

Academic partnerships Research collaborations Teaching Internships and practicums

Complexity requires capacity Vital Records Assurance Role: Access to Clinical Care Maternal Child Family Health Environ-mental Public Health Chronic Disease Control & Injury Prevention Communi-cable Disease Control Across all programs: Assessment (surveillance and epidemiology) Emergency preparedness and response (all hazards) Communications Policy development and support Community partnership development Business competencies Jail Health EMS MEO [CLICK THROUGH ANIMATIONS:] The complexity of the metro environment means that we have more work and additional services that we provide. This means that we need more capacity within our programs to meet the need. And that requires us to have more capacity within the programs that cut across our department that make it possible to do our work, like communications, assessment, and policy development.