Public Health

A public agency which often flies under the radar is the public health office, known in Montana state wide as the Department of Public Health and Human Services, and locally staffed by Darlynn Williams, Powder River County Public Health Nurse, and Sean Hill, Powder River County Public Health Officer. The county also has a Public Health Board which provides guidance in its decision process. This board is currently manned by the county commissioners, as well as Peggy Fruit as the Town of Broadus representative, with a public member position currently in need of being filled.

Public health is defined as the activity that society undertakes to assure the conditions in which people can be healthy. The use of the word "people" is something which separates public health from medical and social care, in that public health deals with populations rather than individuals, working on the community as a whole.

According to the Montana DPHHS 2015 Guidebook for Board of Health Members, public health services are largely delivered in six areas:

• Prevention of epidemics and the spread of disease

• Protection against environmental hazards

• Prevention of injuries

• Promotion of healthy behaviors

• Preparing for, responding to, and recovering from public health emergencies

• Assuring the quality and accessibility of health services

Locally, the Public Health Board and Public Health Officer are tasked with the role of ensuring public and safety within our community. This provides to individuals relative assurances they are eating safe food, are able to interact with the public without the concern of being exposed to communicable disease, and the products they purchase meet safety requirements.

One of the board's duties is to appoint a Public Health Officer – in Powder River County that role is held by Sean Hill. As per Montana statute, the Health Officer must hold an advanced degree in public health or be a physician – Sean has a Master's in Public Health.

Sean tells us about his duties, as well as those of the board: "The authorities granted to Boards of Health and the Health Officer are derived from Montana Annotated Code 50-2-118, which provides for both the steps needed to protect public health and safety and the oversight to ensure individual rights are not violated.

During the COVID-19 Pandemic, many of these steps have been taken, and in Powder River County, Public Health has found that given education, understanding and assistance, community members maintained healthy practices without the need for further enforcement. Members of the community have been quick to complete wellness checks on one another and call Public Health with questions to get accurate information and updates."

Darlynn Williams, Public Health Nurse, provides a multitude of roles for the community. She told us about her duties: "I provide Immunizations, Public Health Emergency Preparedness, Tobacco Prevention, and Family Planning. In bigger offices each one of these would have their own staff."

Going into a little more depth, she described the main focuses of her programs:

Immunization program – We keep a supply of private vaccines and also participate in the Vaccines For Children (VFC) program. This program supplies vaccine to children who have no insurance or on Medicaid. Public Health provides all recommended vaccines for children age 18 and younger. In addition, adult vaccines are in stock also.

PHEP – Public Health participates in a grant that directs the maintenance of emergency plans. These plans include communicable disease, continuity of operations, investigation of foodborne illness, non-pharmaceutical plans, disease surveillance, and hazards such as wildfire or chemical release.

Tobacco Prevention – Public Health participates in a grant that works to educate the public on the harms of tobacco, reduce youth use of tobacco and tobacco products, educate the public and enforce the Clean Indoor Air Act, and prevent big tobacco from targeting teens.

Family Planning – this program is a satellite program of OneHealth in Miles City. The program provides education, exams, STD testing and a variety of birth control methods.

As part of Darlynn's duties, she also works with a number of local and area committees and boards. She said: "I participate in the Council on Aging, the Health Board, Local Emergency Preparedness Committee, and Child and Adult Protection Teams. I sit on the board for Eastern Montana Community Mental Health Center, and I also work with the Powder River Extension Office on the community garden, walking trails and exercise programs. I provide monthly blood pressure checks at the Senior Center and provide vision & hearing screening services to the schools and work with them on immunization requirements. Additionally, I work with OneHealth in Miles City to have WIC services provided locally.

Public Health History

Public health was first utilized to protect citizens in the face of epidemics. During the "Black Death" – the bubonic plague outbreaks which ravaged Europe during the 1300s, killing an estimated 30-60% of the population, some locales used quarantine to ward off the plague. City officials in Dubrovnik (on the Adriatic coast of present day Croatia), issued a public health order which read: "those who come from plague-infested areas shall not enter [Ragusa, as it was then known] or its district unless they spend a month on the islet of Mrkan or in the town of Cavtat, for the purpose of disinfection."

By 1701, Massachusetts passed laws for isolation of smallpox patients, as well as ship quarantine laws. By the time the US Constitution was written and still in infancy, many cities in the fledgling United States had permanent councils to enforce quarantine and isolation laws.

In the 1800s, the Industrial Revolution and increasing urbanization gave rise to squalid environmental conditions. This is where public health really took off, with the rise of sanitary commissions in major cities to perform tasks such as cleaning up water supplies to prevent cholera, and creating waste management systems to prevent dumping of human waste in the streets.

With the rise of understanding in the causes of disease and how they were spread during the late 1800s, state run public health offices took shape.

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In 1901, the Montana Board of Health was created – the precursor of today's DPHHS and DEQ. One of their first acts was to require children in Montana to be vaccinated for smallpox. Though a vaccine had originally been created in 1796, the pestilence continued to ravage populations into the early 20th century, in large part because wide swaths of the population went unvaccinated.

Another example of the success of public health vaccination programs is that of polio.

In the early 1950s, polio ravaged entire communities across the United States. In 1952, the US had 58,000 cases, over 3,000 deaths, and tens of thousands paralyzed by the poliovirus.

Following the introduction of Jonas Salk's polio vaccine, a huge public health campaign took place, with over 1.8 million schoolchildren taking place in the trial. The vaccine was a resounding success, and by 1955 a massive campaign to vaccinate the populace took place, with over 98 million Americans vaccinated between 1955 and the early '60s. By 1961, only 161 polio cases were reported in the US, and by 1979 polio was declared eradicated in the US.

Other examples of public health in action are all around us: seat belts in vehicles, increased worker safety such as recognizing and treating coal miners' "black lung", decreases in infant mortality from access to better family planning services and prenatal care, recognition of tobacco as a health hazard, and many, many more.

In 1900, the average life expectancy of a child born in the United States was 47.3 years. By 2010, life expectancy in the US had grown to 78.6 years. Researchers with the CDC attribute 25 of those 31.3 years in life gained to the work of public health advances.

~ BS