Public health is undergoing a massive change in Oregon after the Legislature passed its modernization bill in July. Since then, the Oregon Health Authority and local public health agencies have been working at a fever pitch to define foundational capabilities – with a goal of creating a set of temporary rules this fall.
“The pace is incredible. We’re just trying to get down what is, what we’re doing now. We haven’t been able to be visionary,” Loreen Nichols, director of Community Health Services for the Multnomah County Health Department, told the Public Health Advisory Board last Friday.
“As this work gets done, and as people step back and read it, the vision will come. People will come up with recommendations,” said Lillian Shirley, director of OHA’s Public Health Division. “This is really groundbreaking. Nobody has said ‘what do we mean by these words?’ CDC has a different mental model from what I do. Can we in Oregon at least when we get together…can we all mean the same thing from the state to the local to the academic perspective?”
Public health modernization calls for system change, not program change – a process Shirley described as “not seamless, not pretty“ and for now, “none of it is set in stone. This is only a beginning step.”
State Epidemiologist Katrina Hedberg shared more details of other changes affecting Oregon’s State Health Improvement Plan, a process she described as “building the boat as we’re sailing across the ocean.”
Among topics generating the most discussion:
- Retail marijuana sales from medical dispensaries begin Oct. 1 with OHA, alongside other state agencies, responsible for some inspection and regulation along with packaging and labeling rules. Five cents on every dollar of taxes collected from retail marijuana sales will go to prevention efforts.
- Electronic health records provide more concrete ways for public health to collect data than surveys on tobacco, marijuana and alcohol use, obesity and the like but face their own limits. Currently, questions are about smoking – not increasingly popular vaping. Unless vaping rates are captured, nicotine addiction may go unreported. Marijuana use questions fall under the category of drug use, which also might not get reported when retail sales are legal.
- Morbidity and mortality data look at what has already happened when data now exists that could be integrated to drive better outcomes. Coordinated care organizations collect reams of data but look only at metrics data.
- Members of the public also expressed options on the benefits of medical marijuana for cancer patients and requested the PHAB make Hepatitis C testing a public health priority and to remember the LGBT community in suicide prevention efforts.
Jan can be reached at [email protected].
