We need public health now more than ever
I’m proud to be a nurse practitioner. I have worked in the nursing field for more than 25 years; the last five years of my career were with the state of New Mexico Department of Health. Having served in Albuquerque, Las Vegas and Santa Fe Department of Health offices, I know what public health means to our state. But I have grave concerns about the Department of Health’s direction with public health.
One of the department’s most important functions is providing clinical services, including a wide variety of reproductive health services. But during the last few years, state health officials have essentially closed down clinical services in two of our state’s public health offices and have severely reduced these services at several others.
Specifically, the Santa Fe office has been without most clinical services for more than a year, and the Alamosa public health office in west Albuquerque has been closed to all clinical services for over a year. In addition, many of the public health offices in the northeast region of the state, which are primarily rural clinics, now offer far fewer services than they did a year or two ago. This loss of clinical services is unacceptable.
The clientele at these offices — the undocumented, the working poor and adolescents — really need basic reproductive health services. It’s important to serve the undocumented because there are so few services available to them. Among the working poor, public health has long been a refuge; and teenage residents flock to them because they can get unbiased health information and services. These clients, typically poor, often cannot afford health insurance.
Martinez administration officials have pushed for these office closures as a necessary change in the role of public health — away from direct services and toward a nebulous new goal that has never been fully specified. The Santa Fe office, for example, is now being touted by Health Department higher-ups as a “food depot” where people can obtain fresh fruit and vegetables under the “MoGrow” mobile grocery program; however, the only people who seem to be taking advantage of this food service are state of New Mexico employees — not the general public. Other services are a low priority. For example, teens seeking information and services for family planning are now being directed to the Española or Las Vegas public health offices. Just how they are supposed to get to and from offices that are at least 45 minutes away is not, apparently, a concern to these elite bureaucrats.
Public health always has been the safety net for those in our communities, large and small, where there are often few other options available. To say that direct client services are no longer needed in these communities is, at best, misinformed; at worst, it betrays mixed-up administrative priorities. While I worked for the Department of Health, a supervisor informed me that public health would be operated “as a business,” meaning that the goal of public health was to generate revenues. That philosophy is wrong. Attempting to balance state budget shortfalls on the backs of the poor is completely misguided, reprehensible and poor public policy.
The state’s bureaucratic indifference may well cause huge future problems. If these offices stay closed, and clinical services remain largely unavailable, we should not be surprised if we see a rise in adolescent pregnancy rates or exploding levels of sexually transmitted diseases. Who will respond to the next widespread disease outbreak or be available to distribute medications if an airborne or waterborne virus attacks our residents? We need public health now more than ever. Our communities depend on it.
Candace Norris is a retired nurse practitioner who has lived in Santa Fe for the last 10 years.