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Half of Pennsylvania residents live in area without a local health department, and rely on the state

Dr. Debra Bogen.
Allegheny County
Allegheny County Health Director Dr. Debra Bogen has regularly given updates on the county's COVID-19 cases, hospital capacity, and efforts to vaccinate residents.

On today’s episode of The Confluence: Spotlight PA reporter Jamie Martines explains how a lack of uniform health department coverage across the state impacts communities; the first cohort of Pittsburgh Food Equity Ambassadors has released their policy recommendations to support a just food system in the city; and the number of low-income families in Pennsylvania accessing subsidized child care has dropped since the start of the pandemic. 

More than half of PA residents live somewhere without a local health department. What did that mean during the pandemic? 
(0:00 - 5:38)

Throughout the pandemic, public health officials have been holding press conferences, sending out releases, coordinating to address the spread of COVID-19. But local health departments aren't in every community. Roughly half of Pennsylvanians live in a county or city with health departments, including Allegheny, Bucks, Chester, Erie, Montgomery, and Philadelphia. The cities of Allentown, Bethlehem, Wilkes-Barre, and York have city health departments.

The rest of the commonwealth currently relies on the state's public health resources.

Jamie Martines, an investigative reporter with Spotlight PA, says local health departments have garnered more attention in the pandemic, but their typical responsibilities include immunizations, public education, and monitoring outbreaks of diseases like sexually transmitted infections.

“I think a lot of people don't think about their local health department or their State Department until they really need it,” says Martines. “But in reality, … people who are providing these services for us are doing a lot of work behind the scenes that we don't even see or think about every single day.”

The state employs 170 community health nurses to address needs for municipalities without county health agencies, including contact tracing, which was sorely needed during the early days of the pandemic.

Martines says it’s not clear if counties with public health agencies fared better than those without during the pandemic, because so many other issues contribute to public health.

“I think we'll see what the experts come up with down the line, when we're farther out from the pandemic, if there is a way to zoom out and see, what did success look like during the pandemic?” says Martines. “There are some folks on the ground who said that deploying resources and finding weak spots was a lot easier in places with the local health department just because they had those lines of communication set up.”

Martines says there is growing interest in some counties to now develop their own health departments, which some experts told Martines this a common response in the aftermath of an emergency, and it will take ongoing commitment to fund these efforts.

The state legislature must approve the formation of a local county health department. Delaware County is expected to launch its new health department this year.

The first cohort of Food Equity Ambassadors have made recommendations to the city 
(5:43 - 15:42)

Accessing fresh, healthy foods means traveling outside of their community for some residents in Pittsburgh, particularly those in neighborhoods with majority Black residents. The Pittsburgh Food Equity Ambassadors have delivered their recommendations to Mayor Ed Gainey’s administration on how to create an equitable and just food system in the city of Pittsburgh.

“The ambassadors were selected to represent each of the city council districts across the city of Pittsburgh,” says Dawn Plummer, executive director of the Pittsburgh Food Policy Council. “Once we came together with a cohort of resident leaders, we met over nine sessions and discussed what everyone was seeing on the ground and what kind of solutions really felt urgent.”

Zinna Scott helped craft these recommendations as a food ambassadors.

“I live in a food desert with many senior citizens that don't have transportation,” says Scott, a resident of Homewood. “When the pandemic started, it became very open how badly they needed food and needed help.”

Scott says residents aren’t informed about where to find resources for food, which ultimately makes access all the more difficult. Of the six recommendations made by the ambassadors, Scott says one of the most important is creating, “alternative food buying options.”

“Ways of getting your food other than going to a Giant Eagle,” explains Scott. “[Not everybody has] the money, so you need to have alternative ideas of how people can get food, whether it's growing it, whether it's using SNAP [Supplemental Nutrition Assistance Program], whether it's getting it by bartering, other things, you have to have alternative means.”

Scott says she would like herself and fellow ambassadors to continue their involvement in policy decisions, not just relegated to the background.

The Pittsburgh Food Policy Council is accepting applications for its next cohort of ambassadors. The deadline to apply is March 13.

Child care needs have become more intense during the pandemic
(15:45 - 22:30)

Finding safe and reliable child care has been harder than ever for working parents, especially during this most recent phase of the pandemic. But despite this high demand, enrollment in a state program that makes child care more affordable for families has declined by tens of thousands.

90.5 WESA’s Kate Giammarise looked into this issue in a joint reporting project with Ed Mahon of Spotlight PA.

The Confluence, where the news comes together, is 90.5 WESA’s daily news program. Tune in Monday to Thursday at 9 a.m. and 7:30 p.m. to hear newsmakers and innovators take an in-depth look at stories important to the Pittsburgh region. Find more episodes of The Confluence here or wherever you get your podcasts.

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