School of public health? It’s not the best solution

Iread with interest the piece by Sens. George Muñoz, Joe Cervantes, Martin Hickey and Jerry Ortiz y Pino advocating for a school of public health in New Mexico (“A school of public health will transform New Mexico,” My View, Jan. 16).

I must first state that I have tremendous respect for New Mexico legislators who have to make tough decisions on policy and funding with typically limited resources, all for no salary. This year, the Legislature has a budget windfall, largely tied to increased revenue from oil and gas taxes, along with an economy beginning to open up from a devastating pandemic. I have a different take on the need for a school of public health and budget priorities for the state.

The pandemic was handled badly primarily at the federal level with the delayed testing rollout at the Centers for Disease Control and Prevention; the early and unnecessarily confused approach from the surgeon general, Dr. Anthony Fauci and others on masks; the Food and Drug Administration’s snail-pace approval of private, commercial laboratory testing; and the implementation of mass business closures of questionable efficacy.

As a result, the pandemic has cost businesses and the federal government trillions of dollars, and states billions of dollars, from health care costs, unemployment, loss of productivity, educational delays and opportunity costs.

I would argue that a school of public health in New Mexico would likely not have changed those failures.

The approach advocated by our senators does not mention any resources for our public health infrastructure in the New Mexico Department of Health: the epidemiologists who tracked cases, hospitalizations and deaths, and provided input on pandemic management; the

Scientific Laboratory Division that performed testing; the Vital Records staff who collect and analyze death certificates; and the public health nurses who are the backbone of public health.

The senators believe health policy formulation is flying blind with the lack of analysis of medical care outcomes and data. I would point them to the Department of Health website and have them click on health data. There one will find a smorgasbord of information: vital records of New Mexico births and deaths, leading causes of death and much more; in-depth information and data on infectious diseases and injuries; impacts of substance abuse; results of surveys of adult and school-aged children’s risks and behaviors; and social determinants of health, to name a few.

Remember the Health Policy Commission? Its members were charged with providing the Legislature with analysis of data to assist them with policy formulation. The commission was put to rest a number of years ago, but the Epidemiology and Response Division in the Department of Health picked up the hospital inpatient discharge data system and continues it to this day. None of these data systems happened by accident. It took years, decades, of hard work by staff. The University of New Mexico and New Mexico State University would have a hard time coming close to this achievement in the short or even long run. The Department of Health also has statutory authority for some of these data systems.

I would offer the following recommendations to the Legislature:

Consider an expansion to the Department of Health to provide specific analysis beyond what is already provided. A couple of fulltime equivalent positions could do a lot of analysis. There may be additional needs for laboratory scientists and public health nurses.

The cost of establishing a school of public health is enormous, and it would not be a onetime expense. Instead, establish a scholarship fund for New Mexico students to attend well-established schools of public health.

Establish a state stockpile of drugs, personal protective equipment and medical equipment that would be rotated with the hospitals and clinics in the state to avoid product expiration. The cost of this is likely several million dollars to do it right.

Query the executive on plans for ongoing, future pandemic planning and preparedness. Those who refused to get on board previously with pandemic planning might have a different attitude now.

Save some of the windfall in a rainy-day fund. The state will surely need it at some point in the future.

In summary, the budget windfall for the state is not likely to last. There already exists tremendous data and analytic capability in the Department of Health. The job market for school of public health graduates is fairly limited to state and federal government and some private sector employers. All of the above recommendations would cost far less than establishing a school of public health in the state and have more direct benefit to the citizens.

In addition, there will be future pandemics. Just because it has been about 100 years since the last major influenza pandemic doesn’t mean it will be another 100 years until the next one. We are in a much different world than that which existed in 1918. A disease that appears in one part of the world today can be in other countries in a matter of hours or days.

C. Mack Sewell is a retired New Mexico state epidemiologist. He lives in Timnath, Colo.