Patricia M. Sweeney, JD, MPH, RN

1
State Public Health Laws and Municipal Codes
Using Existing Law to Strengthen the
Pennsylvania Public Health Infrastructure PPHA
Annual Meeting, November 18, 2007

• Patricia M. Sweeney, JD, MPH, RN
• Elizabeth Ferrell Bjerke, JD
• University of Pittsburgh
• Graduate School of Public Health
• Center for Public Health Preparedness

2
Set the stage PA health status

• (1 best 50 worst)
• 46th in breast cancer deaths/100,000
• 39th in colorectal cancer deaths/100,000
• 14th in quality of health care services
• 39th in overall health
• (1 worst - 50 best)
• 5th in the nation for highest number of new
  cancer cases in 2008
• The Commonwealth Fund 2007

3
Set the stage PA public health workforce
NY 73/100,000
PA 37/100,000
OH 67/100,000
NJ 65/100,000
WV 244/100,000
Public Health Workforce Enumeration 2000
4
Set the stage- PA Public Health legal
infrastructure

• Local Health Administration Law 16 PaCS 12001
  et seq.
• The Pennsylvania Code 28 Pa Code 13.1 et .seq.
• Disease Prevention and Control Law 35 PaCS
  521.1 et seq.
• The State Department of Public Health,
  County/Municipal Health Departments and local
  health officers
• Funding
• Administration
• Programs and governance
• Authority to act to prevent and control spread of
  disease

5
Pennsylvania

• 67 Counties

State Department of Health
67 Counties
County Health Departments Municipal Health
Departments
6
Local Health Officials
Of remaining 2,567 Municipalities
lt 240 Local Health Officers
7
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flashback PA health status

• (1 best 50 worst)
• 46th in breast cancer deaths/100,000
• 39th in colorectal cancer deaths/100,000
• 14th in quality of health care services
• 39th in overall health
• (1 worst - 50 best)
• 5th in the nation for highest number of new
  cancer cases in 2008
• The Commonwealth Fund 2007

9
flashback PA public health workforce
LOWEST IN THE NATION
PA 37/100,000
Public Health Workforce Enumeration 2000
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Legislative Response

• 2001-2007
• Bills introduced to improve Public Health
• Infrastructure
• NONE have become law

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Alternative statutory public health authority

• County and Municipal Codes
• 1st, 2nd, 2nd A and 3rd class counties
• 4th 8th class counties
• 1st, 2nd and 3rd class cities
• Boroughs
• 1st and 2nd class townships

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County and Municipal Codes
1458
13
Local Health Officials
Of remaining 2,567 Municipalities
lt 240 Local Health Officers
gt2,100 Municipalities have the statutory
authority to establish a formal local public
health presence
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Local public health ordinances and regulations

• 11 - 3rd class counties
• 53 - 3rd class cities
• 960 - Boroughs
• 91 - 1st class townships
• 1458 - 2nd class townships

?
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To Improve Local Public Health Infrastructure ...

• Identify the actual distribution of public health
  authority across the Commonwealth
• Catalogue all local ordinances addressing public
  health responsibilities

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To Improve Local Public Health Infrastructure ...

• 3. Partner with municipal governing bodies to
  craft public health ordinances
• Nuisance abatement
• Disease surveillance
• Disease mitigation and control strategies

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To Improve Local Public Health Infrastructure ...

• 4. Provide training for an expanded cadre of
  local public health officers and local boards of
  health

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To Improve Local Public Health Infrastructure ...

• 5. Educate Legislature
• Municipal code opportunities
• Revise Public Health Law
• Senate Resolution 194

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Pennsylvania of the future ?

• 67 Counties

State Department of Health
67 Counties
County Health Departments
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Acknowledgements

• The University of Pittsburgh Center for Public
  Health Preparedness is funded by the Centers for
  Disease Control and Prevention in cooperation
  with the Association of Schools of Public Health.
• Visit www.prepare.pitt.edu or psweeney_at_pitt.edu
  for more information.