As a public health professional, I’m frequently asked, “What is public health?” The simple answer is that public health is dedicated to improving the health and quality of life of all people – our friends, neighbors and those we will never meet.

To accomplish this, public health professionals work together across a range of fields and professions to create policies, systems and environments that promote and protect health where we live, learn, work and play.

We are focused on improving the factors that control our health, such as clean air and water, access to affordable health care, safe places to be active and ensuring adequately funded public health departments, programs and workforce.

April 2-8 is National Public Health Week, which means that several organizations across the state, including Portland’s Division of Public Health, will be holding events and sharing information to educate and promote awareness about public health. (To see a list of events, visit the Maine Public Health Association’s Facebook page.)

Maine is grappling with many public health challenges. Since 2011, the state has forfeited nearly $2 billion in federal funds for public health efforts, including opioid treatment and affordable child care.

And, just over a year ago, the state dismantled 27 health coalitions that served every community in Maine and ensured local oversight and coordination of public health efforts. Not surprisingly, the termination of those coalitions dramatically cut Mainers’ access to public health resources.

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Promisingly, there are opportunities to promote and protect public health in Maine. Last fall, Maine legislators voted to support an increase in Maine’s public health nursing workforce.

Public health nurses mobilize vaccine clinics during disease outbreaks; they visit new moms and their babies to make sure they have the care they need, and they visit people with infectious diseases, like tuberculosis, to make sure they are taking their medications.

At one point, Maine had more than 50 public health nurses, serving a state of 1.3 million residents, across a geographic span of 35,385 square miles. Since this bill passed, however, the state has not appreciably expanded the ranks of field-based public health nurses. If there were to be an infectious disease outbreak, the state would be woefully underprepared.

Last fall, Maine voters overwhelmingly approved Medicaid expansion, which would increase access to affordable health care for an estimated 70,000 Mainers, and would leverage a 9-to-1 federal match for most new enrollees, strengthening the state’s economy, protecting hospitals and creating thousands of new jobs.

The estimated cost of expansion is $55 million (in fiscal 2021), and there is nearly $130 million in surplus revenues, so the state has sufficient resources to cover the cost of coverage. However, Medicaid expansion has yet to be implemented.

Lastly, legislators have an opportunity to ensure our children learn in safe environments.

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A proposal by state Sen. Rebecca Millett, L.D. 40, requires all schools to test water used for drinking or culinary purposes for lead, using water testing kits or by submitting samples of water to an approved laboratory for lead testing.

It also provides that water lead abatement or mitigation efforts will receive Priority 1 status for receipt of funds from the School Renovation and Revolving Fund. As we have learned from the ongoing crisis in Flint, Michigan, lead exposure causes serious health problems, particularly for young children.

Their smaller, developing bodies increase their susceptibility to absorbing and retaining lead, leading to a range of possible detrimental health effects, including headaches, stomach pain, behavioral problems, anemia and deficits in cognitive function.

L.D. 40 is a step in the right direction to assure all children have the opportunity to learn in a safe environment.

Maine is faced with several more public health challenges: We are in the midst of an opioid epidemic, a higher-than-national average youth smoking rate, and the highest rate in New England of adults lacking health insurance.

We have a lot of work to do, but we can make great things happen. It takes everyone in the state pitching in and contacting their legislators about supporting water testing in schools, Medicaid expansion, and restoring the state’s public health nursing workforce. Become a public health champion and support the health of your friends, family, neighbors and strangers.

There’s a reason our state motto is Dirigo. It’s time for Maine to start leading once again.


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