Melissa Lyon is set to begin her role as Delaware County’s first health director on Tuesday as COVID and syphillis numbers are at an all-time high and mental health care faces a crisis.
Rosemarie Halt, chairwoman of the Delaware County Board of Health, spoke about these and other health department issues during a presentation hosted by the Delaware Central County League of Women Voters titled “Hot Topic: Building the Delaware County Health Department”.
During the presentation, Halt spoke about the department’s vision and priorities, including optimizing health and health equity, and shared that Lyon, who previously served as director of public health of Erie County, will begin Tuesday in his role in Delaware County.
For more than two years, Delaware County has worked to establish a County Health Service that meets the standards of Law 315 and the Pennsylvania Department of Health. Even during the pandemic, officials kept shifting the goal of opening the department this month.
At the League of Women Voters event, Halt shared some of the information county officials provided to the state when they presented to the Pennsylvania Department of Health for final approval. Halt said she’s “pretty confident” it will happen.
County officials explained that all final documents have been submitted to the state and they expect to hear from them soon regarding an opening date. They added that they were in constant communication with the state about the transition.
The Delaware County Health Department has focused on adopting a Public Health 3.0 model. Halt explained that the initial public health model created in the 1950s was to be an additional provider of services for community members without insurance.
While services will continue to be offered at the department, Halt explained that the modern version has five core tenants, including a chief health strategist who helps determine where health interventions are placed, such as reviewing the top 10 causes of morbidity and treating them; cross-sector collaborations with hospitals and other non-traditional groups such as the Suicide Prevention Task Force; PHAB approval; evaluate the data and be innovative and find funding for it.
She pointed to the need for more specific data, giving as an example higher rates of cancer and asthma for communities along the industrialized I-95 corridor compared to those in the western part of the county bordering Chester County, as a basis for determining and creating strategic interventions. Along the same lines, she said the county has started doing GIS mapping with health factors.
“The Pennsylvania Department of Health is very excited because we would be the first new Public Health 3.0 model health service and they hope we will be the model for future health services in the state,” Halt said.
She also shared the services and programming that will be provided by the county health department, which will be implemented in phases.
The first phase is expected to run through 2024, the department will focus on personal health with all types of vaccinations, not just COVID, maternal and child health and communicable disease control; population health with continued pandemic response, disease surveillance and health education; and environmental health in the form of food, water, sewage and swimming pool inspections.
Although a lawsuit has been filed by seven municipalities – Springfield, Ridley, Aston, Upper Chichester, Darby Township, Tinicum and Marple – seeking an injunction for the county health department to take over municipal inspections, Halt said that would not prevent the opening of the department.
During this time, the department also expects to meet all of the requirements of Law 315 when collecting and analyzing data to work on priority health issues. It will also focus on building and maintaining partnerships with organizations, including medical partners, and communities.
In the first phase, the county hopes to establish a Baby First program, in which a community health worker would meet with each woman who has given birth before she leaves the hospital to describe the services available in the county and determine if they need extra help. They are also considering employing doulas to help with pregnancy and breastfeeding issues.
In a second phase planned between 2023 and 2026, Halt said the health department would add child mortality expansion programs and address violence prevention, housing and food security, air quality and the prevention of lead poisoning.
Capacity will also be expanded in the second phase to meet priority needs not covered by Law 315 requirements and national standards.
After that, resources will be provided so that the people of Delaware County can lead healthy and productive lives, as the department will apply for accreditation, which is a five-year process through the Public Health Accreditation Board.
One of the things the county had to present to the state was what the leading causes of death were in the county, broken down by ethnicity and race. In Delaware County, the leading causes of death are related to heart disease and accidents.
When race is included as a factor, diabetes and assault are the fifth and sixth leading causes of death for Delaware County’s black community, she explained.
“That’s an area that we think we could target as a health department by really looking at what are the underlying causes of that and what are the interventions that might bring some of those numbers down,” Halt said. adding that they would also consider all factors.
Certainly, throughout the pandemic, COVID has been a factor in mortality and health.
Halt said the county has about 72% of the population between the ages of 5 and 100 vaccinated. However, she said she no longer needs to receive the vaccine.
Of the recent Omicron strain, Halt said, “The week before Christmas, I will say alarm bells started ringing in our county.”
She noted the incidence rates, which were 1,483.6 per 100,000 in Delaware County during the week of Jan. 7 and significantly higher than Bucks, Chester and Montgomery counties. She said tracking showed the cases came from holidays and religious gatherings in places.
Halt said recent data gave him hope the county had peaked; however, it will take time to recover.
COVID isn’t the only serious illness facing the county, as Halt said there’s a syphillis outbreak here right now.
From 2017 to 2019 in Delaware County, the chlamydia rate was 888.2 per 100,000 people; the gonorrhea rate was 338.4 per 100,000; and syphillis was 16 per 100,000. Halt said those numbers only doubled.
“Those 2019 numbers are actually quite different,” Halt said. “I can tell you that we have sent a letter to all doctors in Delaware County who may interact with patients with sexually transmitted diseases, because the number has almost doubled in two years. This is not a good trend and we hope to curb it once we are fully activated as a health service.
Another issue on the county’s health plaque is mental health issues and the limited availability of crisis centers.
The Crozer Health System, which has played a significant role in serious mental health issues and crises, is experiencing many financial difficulties and is beginning to close some of them, Halt said.
“As such, the county is now considering working with our Department of Social Services,” she said, adding that they will be reaching out to community partners to strategize on how to address this concern.