In the past, the work of a public health department was a simpler science.
Jimmy Hines, the new director of the Rutherford-Polk-McDowell Health Department, says that in the early days of public health work, new health discoveries made the challenges clear.
“It all started with efforts like garbage collection,” Hines said. “Scientists noted that disease patterns were related to infectious sources. They tracked typhoid to bad water. You could locate it and clean it up.”
A polluted public water well was identified as the source of an 1854 cholera outbreak in London, and its discovery helped establish the germ theory of disease. Previously, doctors had blamed most diseases on “bad air.”
Unfortunately, for modern public health workers like Hines, the problem today is not bug behavior. It is human behavior.
Today, Americans get sick by making unhealthy choices, and to do their jobs public health workers must try to influence better choices.
The main problems plaguing Americans health nowadays, Hines said, are caused by things like sedentary lifestyle, poor diet, tobacco use, substance abuse, obesity, and teen pregnancy.
“Today, people suffer more from chronic diseases than infectious ones,” Hines said in an interview last Thursday, just after being sworn into his new office at the Polk County Health Department office on Walker Street in Columbus.
The department headquarters are located in Spindale.
Hines says what he tries to do as a public health officer is to focus on “policy changes” like smoke-free restaurants, and “environmental changes” like opening up school walking tracks or building more sidewalks. Hines said he wants to foster anything that will help lead us to healthier lifestyles.
“In public health, you cant just say, Youre overweight!” Hines said. “People who are hungry are going to buy foods that bring the biggest bang for the buck, and will buy foods that end their hunger. Unfortunately, eating healthy is not the most cost efficient way to eat in this country. So we work to improve the undergirding factors.
“Were in the solutions business,” he said. “We want to support those efforts that will have the most effect.”
Hines says he is happy to work to see services delivered from any efficient source, including churches and employers.
“We look for ways to help people where they are, and use lots of different strategies,” he said. “I learned as a principal, for instance, if you wanted to get the parents to a meeting, attendance was better when their kids were performing.”
Hines has an $11 million budget and a 150-member staff to try to create solutions for the approximately 100,000 residents of the tri-county area he now serves.
About $700,000 of the health department budget is spent to administer WIC (women, infants and children), a Federal assistance program of the Food and Nutrition Service (FNS) of the United States Department of Agriculture (USDA) for health care and nutrition of low-income, pregnant women, breast feeding women, and infants and children under the age of five.
The eligibility requirement is a family income below 185% of the U.S. Poverty Income Guidelines. In this program, new mothers can receive vouchers to purchase healthy food items.
“A healthy baby is more likely to become a healthier adult, which may lead to less health care cost to society,” Hines said.
The health department also has a home health care division, providing staff to visit patients in their homes on a fee-for-service basis, typically for nursing, physical therapy, speech therapy and other health care services.
The health department runs an Environmental Health Services division, providing health inspections at restaurants and catering kitchens, checking land to determine if it can safely host a septic tank, and investigating lead poisoning incidents. The environmental health staff also works with epidemics and food recalls.
The health department provides immunizations and pre-natal care services. In Polk County, the Collins Dental Clinic is a joint venture with the health department and the Thermal Belt Outreach.
The department also employs a full time health promotions coordinator who works with the Polk Wellness Coalition on issues related to creating a healthier community.
Hines, in his last position, was Director of Community Health Services for the Cleveland County Health Department, and was responsible for marketing, health promotions, strategic planning, grants, and inter-agency cooperation with groups like Smart Start and substance abuse prevention services.
A native of Burlington, N.C., Hines studied public health at East Tennessee State University, and later earned a masters degree in health education at Gardner Webb University in Boiling Springs, N.C. He studied school administration at UNC-Charlotte and served as a school principal in Cleveland County for awhile.
Hines managed a substance abuse agency, Community Organization on Drug Abuse Prevention (CODAP), in Cleveland County, and went to work for the health department when that agency became part of the Cleveland County Health Department.
Hines began his new position as executive director of the Rutherford-Polk-McDowell Health Department March 1st, replacing interim director Phillip Melton, who was and remains the financial director of the department. Former executive director Buck Wilson retired in July 2009.
“Mr. Hines was one of two final candidates for the position who were interviewed by a search committee which took great care and effort to find the best person for the job,” said Dr. Iain Fitch, chairman of Rutherford-Polk-McDowell board. “Mr. Hines qualifications and experience are extensive. The search committee and health board, after interviewing, feel he will be able to use his skills to assimilate into the Rutherford-Polk-McDowell Health Director position quickly and efficiently.”
In addition to his duties working at the Cleveland Health Department, Hines served 20 years as an adjunct professor of health education at Gardner Webb, and has also taught at UNCC and Winthrop University. So he knows public health, both in the academic world and the real world of human behavior and politics.
“Public health is a costly effort at times, with incremental change,” he said, acknowledging that there are some today, particularly in light of sinking government budgets, who think much of the effort is a waste of money. Of course, he disagrees.
“It is kind of a pay me now or pay me later situation,” Hines said. “If we dont try to stop the cycle, if the cycle perpetuates itself, that is very costly. If we provide education and programs to get people healthy and productive and earning, that is much better.
“Obviously people must be part of the solution to improving their health. Finding work is an important factor for improving individual and community health,” he said. “But what is best for the community to increase health? At times, it is simply to help those with the greatest need.”