Delco seeks to build a health department that’s leaner, data-driven, and engages the public

Delaware County opened Pennsylvania’s first new county health department in three decades last April, and over the last year has sought to build a leaner, nimbler public health model to respond to today’s pressing health needs.

Local health departments help manage chronic health problems, track emerging infectious diseases, and educate the public. In Delaware County, officials want to accomplish these core responsibilities while also addressing the complex relationships between environment, economics, race, and access to care, which contribute to chronic health conditions. The department hopes to partner with other government agencies, hospitals, and county nonprofits to directly tackle these so-called social determinants of health.

“We’re in the implementation stage, but I can assure you that is definitely the lens through which we’re building this department,” said Melissa Lyon, the health department director.

The COVID-19 pandemic exposed public health’s weaknesses in getting services to at-risk communities and is shaping the new department’s priorities, which include a focus on emergency response services.

Just seven of Pennsylvania’s 67 counties, including Delaware County, have their own health departments, according to the Pennsylvania Department of Health. Montgomery, Bucks, Chester, and Philadelphia counties also run their own health departments. Lackawanna County is exploring starting one as well, state officials said.

Pennsylvania provides public health services in counties that don’t have their own department.

» READ MORE: Delaware County’s new health department can’t do inspections in eight townships after lawsuit

To be the new-era, leaner health department that Delco administrators envision, health officials sought to coordinate services with existing nonprofits and private health providers.

“We’re not trying to take over the work that they’re doing, but to fill in those gaps,” said Monica Taylor, director of Delaware County Council, who has supported creating health department since she campaigned on issue in 2019.

For instance, health experts want more doulas and community health workers to address the county’s maternal mortality rate and infant mortality rate among Black women and babies. Black women in Delaware County are four times more likely than white women to die during pregnancy or the months following birth. Black babies have an infant mortality rate of nearly 13 deaths per 1,000 live births, according to the county health department, compared to the national rate for black infants, 10 deaths per 1,000 births.

The county received a $1 million federal grant recently and plans to largely disburse the funding to local health organizations already working on maternal and infant health in the community.

» READ MORE: Delaware County hopes to tackle high death rates among infants and mothers with nearly $1 million in federal funding

The approach has strengthened the fledgling department’s relationship with local health organizations, which have more established connections to vulnerable communities.

“The best thing they could do is get to know the work we’re doing, determine we’re doing just fine, and have the confidence they didn’t need to develop programming that was duplicative of the programming we’re already doing,” said Joanne Craig, chief impact officer for The Foundation for Delaware County, and a member of the county’s maternal and child health working group that is eligible to receive some of the federal funds.

Delaware County health advocates have wanted the local department since the 1960s, said Rosemarie Halt, chair of the county’s board of health. With 575,000 residents, Delaware County was the most populous county in the nation without a health department, she said.

A Democratic majority was elected to council in 2019 and voted to create a health department, but then the pandemic hit. Delco officials put their plans on hold and instead contracted with Chester County’s health department for pandemic response.

The country saw the need for local expertise during the pandemic. Many public health agencies had difficulties contact tracing, providing access to COVID-related services, and combating misinformation, said Halt, who also worked as Delaware County’s COVID director.

Delaware County’s health administrators decided they needed to prioritize in-house emergency response, she said. This includes a new call center, based in Eddystone, with four full-time staff trained in contact tracing.

Their efforts paid off in January, when staff were able to contain a tuberculosis case in a Darby middle school, Halt said.

» READ MORE: Delaware County hopes to tackle high death rates among infants and mothers with nearly $1 million in federal funding

Now Halt worries about future funding. The department has an $18.3 million budget, smaller than Montgomery and Chester’s health departments, though more than Bucks County’s. Halt would like to see more financial support from the state for health departments.

“It’s startling to me that after COVID, health departments are still fighting for funding,” she said.

The department’s first community health needs assessment, expected by the end of the year, will inform future projects. Delco officials expect it will provide a deeper assessment than reports from the state.

“I’m really curious to see what it looks like on a micro level,” she said. “The state doesn’t necessarily slice and dice that data in a way that gives us what we like to refer to as a hyperlocal analysis.”

Officials are especially interested to learn more about how Delaware County Memorial Hospital’s closure in Drexel Hill last year has affected access to care. The area lost an emergency department and the only birthing hospital in that part of the county.