Safeguarding Public Health

* Your series on the problems confronting the Los Angeles County Department of Health Services was a terrific one (Oct. 29-Nov. 2), but by concentrating on individual clinical services, it highlighted how we are paying too little attention to the county’s broader role as protector of the overall health of the community. It’s the county health department we rely on to keep us all safe from emerging communicable diseases and to safeguard our neighborhoods from the threats posed by toxic chemicals and other agents.

The health department helps us all by tracking outbreaks of familiar threats such as tuberculosis, measles and sexually transmitted diseases. And it is on the front lines in the battle against new problems such as AIDS. When a community is alarmed by emissions from a etal-plating plant or when a cancer cluster appears at a school, it’s the county health department we look to for answers. The same public health mission is behind the county-run clinics that provide immunizations to low-income children and provide needy women with the basic prenatal care they need to deliver healthy babies.

It’s easy to see why the county’s public health programs have been eclipsed by the struggle to save the hospitals: They account for only 10% of the $2.3-billion budget of the health department. But the smaller cost of the public health programs only underscores their true value. For every dollar spent on preventing tuberculosis among the homeless, the county saves much more in avoided medical care at its clinics and hospitals.

There should be no need to choose between hospitals and public health programs. Our challenge is to incorporate the protective and preventive goals of public health into the efforts that will reshape the county’s vast system of hospitals and health clinics. If we can do this successfully, we will not just be able to maintain the safety net for Los Angeles County’s needy, but we will make the community a healthier place for everyone.

ABDELMONEM A. AFIFI Ph.D.

Dean, UCLA School of Public Health

* Re “Post-Soviet Russia Slips Into Third World’s Sickly Ranks,” Nov. 13:

With all the hard-hearted budget cutting and tax breaks, how long will it be until there is a headline reading “California Slips Into Third World’s Sickly Ranks”?

In a similar vein, with California spending equally on prisons and education, in 30 years, how many people will be very angry if they can’t get medical treatment? All the talk about protecting the future for our children is terribly shortsighted. The Republicans in power in our state and nation are living in an Alice-in-Wonderland world.

BARRY GREENFIELD

West Hollywood