geoff: The covid pandemic
highlighted the power of
agencies like the CDC and local
health departments.
And brought backlash from people
who said those authorities were
overreaching.
In the wake of this turmoil,
many public health departments
have been overhauled, having an
outsized impact on rural parts
of the country.
With support from the pulitzer
center, and in collaboration
with the global health reporting
center, special correspondent
Dr.
Alok Patel has the story from
Colorado.
It's part of our ongoing series,
rural rx.
Dr. Alok Patel: Emily brown is
busy with chores on the family
farm, where they raise cattle
and grow potatoes.
It's a big change from her six
years running the Rio grande
county health department.
Emily: My role as a local public
health director previously had
been pretty low on the radar.
And then covid came along.
>> Covid meant long days
tracking cases, announcing
business closures and travel
restrictions.
>> Covid was hard.
>> And then, two months into the
pandemic, the county
commissioners fired her.
I think it was a culmination of
just a lot of different tensions
that sort of maybe came to a
head.
Brown was the first but not the
last.
Fully half the public health
directors in Colorado have quit
or been fired since March of
2020, a turnover rate that is
alarming to tista Ghosh, the
state's former chief medical
officer.
>> I would call it a nightmare
for most of the public health
community.
It's been a very difficult time
and a lot of people have left.
>> The controversies did not end
with covid.
Until late January, Kayla Marler
was public health director in
Fremont county.
She says her downfall came after
she tried to launch a family
planning program.
>> When it comes to prevention,
especially when it comes to
birth control, it is something
that is needed.
>> In these small mountain
towns, options are few and far
between.
>> And it was really
disheartening as a public health
director,
that I would have to tell my
staff, you're gonna have to let
them know they're gonna have to
go to a neighboring county.
>> Marler secured a grant to
start a program that would offer
birth control, test for sexually
transmitted infections and treat
patients who needed help.
>> October of this last year,
brought it to the board of
health, and it was turned down.
>> So, after they rejected your
proposal, what happened then?
>> What pretty much happened is
I was pushed out, I was pushed
out of my position.
Dr. Alok Patel: County
commissioners say Marler was let
go due to staff morale and
financial incompetence, not
family planning.
But Marler denies any management
problems, and showed us letters
of support she got, from current
staffers.
And it all came down to the vote
by three people.
>> So I had one female and two
males on my board of health.
The two males voted against it
and the female voted for it.
The three individuals you also
have to understand are
politicians.
They are in their position
because they are elected by
their constituents.
They had absolutely no medical
background.
>> I think the debate continues
now
over whether public officials
should be scientific experts who
determine policy, or if that
should be left to elected
officials.
>> That question is playing out
right now in the southwest
corner of the state, where two
counties that have run a joint
health department for the past
75 years, are going through a
divorce.
>> It's just like any
relationship, whether it's a
marriage or not, it takes trust.
>> Marsha porter-norton is a la
plata county commissioner, who
voted to stand up a new health
department.
And end a long-standing
relationship with neighboring
Archuleta county.
The soon-to-be dissolved
organization is San Juan basin
public health, where liane
jollon has been executive
director for 13 years.
>> We do everything from
restaurant inspections to
childcare inspections to
tracking exposure to lead for
children.
We do things like ensure that
people have access to family
planning and contraception.
We do breast and cervical cancer
screenings.
We do lots of family formation
and early childhood programs.
We have a water lab that tests
drinking water.
>> When the pandemic came, San
Juan basin jumped right in.
>> We went into that response
mode in the first week in March,
which was extraordinarily early
for a local public health
department.
>> But the response wasn't
popular with everyone.
Protestors returned to the home
of the executive director of the
San Juan basin health
department, liane jollon.
>> And then the cops moved them
to that hillside, and now they
are saying the public health
director who's taking away your
freedoms lives right here.
And that was difficult.
>> At first, it was protestors
in Archuleta county who wanted
to break up the department.
But ultimately, it was officials
in la plata county who pulled
the plug.
>> I think the pandemic laid
bare
a lot of differences in values.
I failed to see how we were
going to go forward in the
future and have the kind of
public health that I expect,
which is what San Juan basin is
delivering now.
They're delivering really good
public health.
>> Shere Byrd is a biology
professor at ft.
Lewis college.
She sits on the board of health,
which recommended the split.
People in Archuletta county came
to meetings with guns on their
hips.
It was just an untenable
situation.
>> But standing up a new health
department comes with a big
price.
A consultant hired by la plata
county released a report last
month, which said this county of
56,000 people will have to find
nearly a half-million dollars a
year to maintain the same
services, on top of the
transition cost -- nearly a
million dollars.
The report suggested staff would
be cut by more than a third.
>> If you're talking about 40%
fewer people, it's gonna have an
impact.
>> Can you tell me how you felt
when you first learned about the
vote that San Juan basin was
gonna be dissolved?
>> Well, we were devastated.
>> Dr.
Rhonda Webb is chief executive
at the pagosa springs medical
center, in Archuleta county.
The only hospital for more than
50 miles around.
>> People in rural areas just
don't have as good of access of
healthcare, right.
They, they just, they don't.
So public health has to step in
for those people and be there
for them where they need to be.
>> Archuleta county, like much
of rural Colorado, has a
shortage of primary health
providers.
And Webb says rural counties
have a lot to lose, if public
health funding is cut back.
>> Hospitals take care of your
wellness overall.
They take care of people with
individual health conditions.
But the public health takes care
of the health of our whole
community.
The center for disease control
and prevention is advising that
cloth-based coverings no longer,
>> She says the community isn't
fully aware of what's at stake.
>> It's like, oh fine, masking
and vaccines.
But what about sewers and
restaurant inspections and all
air quality when there's a fire?
Who's doing that?
It's the public health
department.
>> The current arrangement funds
the department through December,
when much of the staff might
join Kayla Marler, on the
sidelines.
Marler she says that subsequent
events have proven she was on
the right path.
>> Family planning got approved
by the board of health.
It was no longer than two weeks
after that I was notified, we
have a huge syphilis outbreak.
We are needing to do something.
And I'm sitting here like oh
, yeah, we need to do something
in an back of my mind knowing we
had a plan in place and that was
family planning.
>> Who or what is affected when
politicians get to make these
public health decisions?
>> The people that are impacted
are the residents.
There is no room for politics to
be in public health.
>> But with memories of the
pandemic still fresh, the
trendline may be moving in the
opposite direction.
For "The pbs newshour," I'm Dr.
Alok Patel, in rural Colorado.
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