(upbeat music) (graphic pops) - Hello, and welcome to "The Journal," I'm Steve Kendall.

County health departments are tasked with guarding our health in a wide variety of ways, preventing disease, promoting wellness, and protecting the environment.

Joining us are three members of the Seneca County Health Department today, Julie Richards, Cat Dennison, and Harold Huffman.

Thank you all for being here to talk about the important work that you do.

Julie, you're the health commissioner.

Kind of give us an overview of the range of things you do.

I mentioned generally, but it's a lot more detailed than that, but talk about what a day is like for you guys, what you typically look at every day.

- [Julie] There really is no typical day, is what I'm finding, and I'm a relatively new health commissioner, and so we comprise ourselves of an environmental division, a nursing division, WIC division, which is Women, Infants, and Children.

We have an epidemiologist, we have emergency planning, a fiscal department.

So we have a pretty comprehensive setup to help protect the citizens of Seneca County.

- Yeah, and when you, I mentioned in general, but some of the things, I mean, right now, what's the main focus as we sit here on late February?

What's at the top of the list that you're watching right now in Seneca County?

- [Julie] Oh, goodness.

That really depends on the day as well.

I would say in disease surveillance is always on the top of our list for what we look to- [Steve] Because we're kind of in respiratory virus season, so that's, you see that a lot at the top of news stories and that sort of thing.

So what kind of things do you, if you've got a situation like that where we're looking at the flu or whatever, what kind of things do you do then to make sure people are aware of good habits and prevention and what to watch out for and symptoms and things like that?

How do you reach out to them?

- [Julie] Sure, we have kind of a comprehensive approach.

We use our social media to provide information.

The newspaper, we're used to using newspaper as well, events and opportunities like this to raise awareness, but probably best would be to let Cat speak a little bit about what she does for disease prevention.

- Yeah, because yeah, you're listed as the epidemiologist and emergency planner and that sort of thing.

So yeah, talk about your role.

- Yeah, so primarily with epidemiology, the field itself looks at what causes disease and then how to prevent those diseases, as well as how disease distributes itself throughout a given population.

So some of the time with prevention, especially, like I work a lot with our long-term care facilities.

So sometimes I'll get calls from their nursing directors or infection preventionists wanting to talk through ways to keep their residents safe.

I also work a lot with them when there are outbreaks of different things, if that is happening.

But from a surveillance side, I look at a few different things to watch respiratory disease activity.

One is through like direct case reports that we'll get from labs, or I also look at something called syndromic surveillance.

So when people go to the doctor or they go to the hospital and they're presenting with certain symptoms that are similar to different respiratory viruses, that'll go into a system that the whole state uses actually.

And that's a way for us to look at how many people are seeking care for different illnesses.

- And you mentioned that too, because obviously you're not in isolation, just as things don't stop at the county border, but you're watching what goes on and you're in touch and in communication with other health departments around the state so you can be prepared or looking ahead like, okay, this is going on in Mercer County.

What does that mean?

Is this something we need to be watching out for?

Do you guys share a lot of information with your colleagues at different other health departments as you go along besides the databasing and that sort of thing, Harold?

- [Harold] Well, Steve, it's interesting that even to expand outside of Seneca County and your comment about not stopping at the borders, I monitor intelligence from Homeland Security as well.

And so if there's a disease spike that's going on, say in Sudan, I'll reach out to our epidemiologist and ask if she's aware of this case and what symptoms we're seeing in Sudan, what she's seeing in Ohio or the neighboring states with the idea of in Seneca County at the health department, we wanna stay ahead of anything that's potentially emerging and it goes from the county all the way out to the global perspective in case there's a disease agent that whether natural or a man-made is starting to develop itself in some foreign land, we wanna know that before it gets here on our soil and then within our county.

- Yeah, well, that's a good thing because I think people probably aren't aware that you guys have that kind of global reach.

It isn't just what's happening in Ohio, what's happening in county or city.

All of that affects everything, that sort of global situation as we saw a few years ago during the pandemic, it started in one place and suddenly it was global.

When you talk about things that I know is, there's a reference, I know you sent me some points like talking about Epi 101, is that epidemiology 101 or is that a specific?

Okay, so what is Epi 101?

Let's all learn so we can say, I took the Epi 101 class.

Yeah.

Talk me through this, yeah.

- [Cat] Well, so kind of a little bit of what I touched on earlier, just about in general, what Epis do, monitoring all the different surveillance and like going back to a typical day earlier, we also Epis don't have a typical day.

It depends on what disease decides it wants to pop up that day.

So a lot of what epidemiology entails is like active case investigation.

So in Ohio, there's a list of diseases that are some mandatory reportable by law.

So whenever a doctor or a lab sees one of those cases, they have to tell the health department and then I have to follow up on it.

And depending on what the disease is, that determines what the investigation looks like.

So some of the time that just is me going through the records, seeing what happened and closing it out.

Other times I'm calling people and conducting interviews because if one person has like a foodborne illness, for example, odds are some other people may also have a foodborne illness.

So I call them and do interviews to try to figure out where it could have come from to ultimately prevent other people from potentially getting sick.

- [Steve] And then your cohorts, your colleagues and other departments do exactly the same thing.

And then all of that information so you can get a complete picture of as much as possible is what's going on.

And you mentioned foodborne illness.

I mean, obviously restaurant inspection is a big part of what you do.

People wanna feel safe when they go out knowing that people are following the rules in terms of hygiene and all of those sort of things and storing the food correctly.

That's not something that we have, we seem to have a lot of issues with.

It isn't as if, oh, every day we have a problem with food safety at a restaurant or a school or an assisted care facility or something like that.

But that's a big part of what you do.

And it does, of course, obviously protect people.

We come back, we can talk a little more about this too.

And then obviously, one of the things that all health departments do is that community health assessment situation, which gives you that snapshot, gives the idea of where you're going and what you need to do in the future.

So we can talk about that as well.

Back in just a moment with Julie Richards, Cat Dennison and Harold Huffman from the Seneca County Health Department here on The Journal.

Thank you for staying with us on The Journal.

Our guests are Julie Richards, Cat Dennison and Harold Huffman from the Seneca County Health Department.

Julie, one of the things that health departments do every three years is what's called the community health assessment.

So talk about what that is and then what the purpose is and then what you do with that once you've gathered all of that information.

- Sure, so the community health assessment is a comprehensive approach to determine current health risks within your community.

So it's a compilation of information that's derived from interviews, one-on-one interviews with leaders and individuals throughout the county.

They also do what they call community surveys.

So the survey we advertise through social media, through our clinics and just try to get as many people within Seneca County as possible to complete those surveys to give their feedback on their access to care and their current health concerns.

So they pull all of that information together and put together basically just a comprehensive amount of data that then we take from the Health Alliance perspective, which is our organization, our group that is comprised of community entities and agencies to look at that data and determine initiatives that we want to put into place so that we can improve the quality of health access and care to our community.

- So what would be some of the questions you would ask?

Is this sort of an, I mean, can you go online and fill out a survey or is it?

- Yes, we have a QR code online that people can scan and complete that information.

We also have hard copy surveys within the agency that people can come in and take if they're interested.

We have right now we're in the middle of our next community health assessment and we have just about a thousand respondents.

So that's a really good number for us.

And we're excited about the data that we'll gather from that.

- And you guys, of course, then look at that as well to assess what's going on so you can address that.

So what kind of questions?

I mean, obviously, I mean, if I'm sure for a long time how many people were smoking, the amount they smoked, alcohol, drug consumption, those sorts of things, those are all part of this?

- Those are all part of that, absolutely.

Chronic disease is a part of it.

Access to care, your living situation is part of that.

Mental health has become a larger piece just simply because that number increases with every community health assessment that that need is something that our community must respond to.

- Sure, yeah, and so you guys take all of that information and then look at a way to say, okay, look, we see a developing trend here going in this direction on, as you said, mental health.

What tools can we bring to do that?

So how do you go about then saying, look, here we see a problem developing or one that's already in place.

How do you go about then pulling resources together, you guys, to say, okay, here's how we're gonna address this.

- [Harold] She referenced access to care and just an extension on that comment is we have a number of individuals across our county that would be labeled vulnerable populations.

Maybe they don't have a vehicle.

Well, how do we outreach to them to provide ready access to health care or mental health care so that they're staying as healthy and maintaining a healthy lifestyle as possible?

So educating them oftentimes and going into those neighborhoods potentially that we see more of that population using the census track data and the community health report to identify where those might be.

And then we go into those communities to either provide education or link them to that care.

- [Julie] One of the things we did for this current community health assessment was to do focus groups.

And one of the focus groups that we did this year was to meet with a group of teenagers from local area schools.

And the fascinating thing about that was just to get a good understanding of their take on what current health risks are.

And then to be able to inform and educate them about opportunities and resources that are available within the community that they may not otherwise be aware of.

So between 15 and 18 years of age, they're reaching adulthood.

And to be able to understand that getting a primary care doctor, someone that follows their care on a regular basis versus just going to urgent cares on a random basis whenever they're sick, provides them with a level of care and continuity to keep tabs on what's going on with them and they can make informed decisions then.

- [Steve] Yeah, because their idea of what is a public health concern is probably different than somebody who's 30, 40, 50, 60, whatever, because their lifestyle is different.

Their life experience is different.

So that's interesting.

What was the one thing that roughly came out of that?

I mean, in terms of what was the one thing they said that maybe was the most important thing to them about, or a lack of awareness of some item, like, oh, I didn't know I should have a family practice doctor or I didn't know I should be doing this instead of that.

- [Julie] Yeah, I think the primary care physician was a piece of information that I just really remember thinking, oh, they didn't realize that and how important that could be.

But also nutrition was a big thing and access to healthy nutrition, nutritious foods, as well as the expense of nutritious foods.

And our county is really using some unique approaches to address that in our current health improvement plan, which is what we put together to address those concerns.

- [Steve] Well, it's interesting, because you mentioned the fact that they maybe didn't think about a long-term plan for a primary healthcare, because we've become increasingly used to drive-through service or immediacy, like I just do this when I need it, I don't do an extended look at something.

And you probably see that, Cat, with what you deal with, because people are like, oh, they don't have a long-term plan to address, or aren't worried about RSV until suddenly now they have it, that kind of thing.

Because they're saying, well, I'll just go with the urgent care if I don't feel well, versus having a comprehensive plan to prevent getting in that situation.

So when you do that, you talked about the fact that you go to, I guess, probably what you would somewhat consider a group that is concentrated when it comes to assisted living or care facilities like that.

That's obviously a lot of education you have to do for the people that work there.

Is there an ongoing educational process with those kind of institutions and other places where there are a lot of people concentrated in one location?

- Yeah, so I would do that more with long-term care, but we also have school nurses who work at our health department.

So they do more of the outreach with the schools, unless there's an outbreak of something going on, then I would help with that too.

But yeah, it's just a continuous process.

Because also, some of the time, guidance changes too.

So the health department is expected to be up-to-date on all things related to prevention.

- [Steve] Have the latest information on that, yes.

Yeah, and that's true, because a lot of times people will say, "Well, I remember this is what we used to do.

"That's not a problem, it's not a problem."

Or, "I thought this is how we addressed it."

Well, there's new information all the time, new research, new treatment, new drugs, new whatever.

And probably just keeping up with that is a full-time job.

And so for the average person, they're only as good as the information they can glean from either folks like you or unfortunately other places, maybe the information isn't as accurate as it should be or as close.

Your role, Harold, when you look at some of these things, because I know you're kind of in the planning and prevention stage and sort of the emergency response coordinator.

So what does that mean?

I mean, is your response to specific issues or is it anything that confronts the health department of an emergency nature?

- [Harold] We all work together, and so a lot of our roles cross over.

One of the large focuses that we all have, we've talked about congregate care facilities, but we also are blessed to have two universities in our county.

And so these are individuals that are transitioning into a new place, new lifestyle, new cultures, right, many times.

And so helping them pre-plan for if an emergency happens for some sustainment, but then also finding some of the linkages to care my colleagues have already talked about.

- [Steve] Yeah, okay, good.

Well, we come back, we can talk a little more about that because obviously we know that we're confronted a lot of times with health issues that just come up, although you guys are aware of them to the average person.

It's like, oh, this came out of nowhere, even though that's not the case.

Back in just a moment, representatives from the Seneca County Health Department, Julie Richards, Cat Dennison, and Harold Huffman here on The Journal, back in a moment.

You're with us on "The Journal," our guests are Julie Richards, Cat Dennison, and Harold Huffman at the Seneca County Health Department.

Harold, part of your title is emergency preparedness, and that's probably a pretty narrow focus, not a lot going on.

- [Harold] Yeah, not a lot.

- Tell us what that means and the scope and what that means to the average person, what you do that they probably don't see all the things going on in the background, but yet, when something happens, you guys are there.

- Certainly, from emergency preparedness, we look at the full spectrum of emergency management, from planning, prevention, response, and recovery.

And so, we spend a lot of time planning for, identifying scenarios, running tabletop exercise, full-scale drills, those sort of things, not only within the health department, but with all of our public safety partners, whether that be law enforcement, fire, medical, and the other entities, as well as the private sector.

Because when something bad happens, as we've seen across our country, whether it be the fires or the floods, we've seen recently, we all have to come together to do our best, right, to help the citizens that live in our jurisdiction.

As a health department, we're organized at the county level, but we're part of a regional group, as well.

And so, our regional group is headquartered right here in Bowling Green, and so, we liaison frequently with Wood County Health Department, as they're the regional hub for us.

And so, a lot of our time is doing those sort of, that preparation and planning, hopefully mitigation.

And in my job, if I can keep everything on that side of the fence, we're doing pretty well, right?

But unfortunately, things happen, right?

Whether those be man-made or natural events, we respond to those.

And as a health department or emergency planning person, I look at disease-related issues, whether that be food-borne issues, or some of the respiratory things we've already spoke about here today.

But then, also, we have the response capability and charge, as a health department, to also respond to other events that might happen, whether those be floods, or home fires, or train derailments, those sort of things.

And oftentimes, when those things that aren't directly health-related, we fall under the EMA, so the Emergency Management Agency, and our county is the hub of the wheel.

And then, all of us other public safety entities are the spokes of that wheel.

And then, we work collaboratively to help protect the safety of individuals who are working that event, the health of individuals in our county, and then the environment, of course.

- [Steve] And you mentioned the fact, too, that you have natural or man-made disasters.

Of course, the initial thing is to address the issue, to secure the situation, make it as safe as possible.

But then, afterwards, there is, as you said, there could be a problem with access to just regular healthcare, because that whole system may have been disrupted by that event.

I mean, if you look at the flooding down in the middle part of the country, people weren't able to get any place, let alone in an emergency situation, or just a regular appointment that they're supposed to get to, to deal with their health issues.

And it's one of those things that kind of is below the surface, that thing that we take for granted, you can always get there some way.

But you guys have to have plans to deal with that, and to make sure people can at least begin to function and back to some level of normalcy.

What's the biggest challenge that you have when those things happen?

Because sometimes we'll hear, oh, there's communication issues.

Some guys, one unit doesn't have the same kind of radio as somebody else, or they've got a different online system to deal with this, and there's access to this system versus that system.

That's being, I assume, worked out now on a lot better scale.

- Yeah, we used to say formally, and you're absolutely correct, is the two first things to break is command and communication.

But I will tell you, in working in this field for over 25 years, that's gone away a lot.

And I'm very happy to see it in Seneca County.

We don't have those issues.

As far as inter-agency communication, we have redundancy in our communications, so our communication system, and we drill to it all the time, and we try to push to failure.

- [Steve] To find the sort of out where, oh, we didn't, yeah, that kind of thing.

- [Harold] And then on the command side of the house, the health commissioner sits side-by-side with all the leadership within the county, and we call it EOC, which is an Emergency Operations Center.

And so when a disaster happens, all of our leadership is in the EOC monitoring the situation, and then kind of offering the global strategy to those of us on the ground, then implement those tactics to meet that strategy.

- [Steve] Now, one of the things that we talked about through the off air is that you have kind of a unique situation that you've got a city that's in three different counties.

That obviously is a little bit of a challenge, because you have to know when someone calls what county they're actually in.

I'm sure you have a policy that routes them to the correct jurisdiction, but that's probably a coordinating situation too, where you have to constantly be in touch with your colleagues at different areas.

So anything there that creates any real problems anymore, or is that with communication being a lot better now, it's not as big an issue as it was?

- [Julie] Yeah, I was gonna say, I think our communication with those other counties is really great, and a great working relationship.

And sometimes if it's an unknown, and we're not quite sure who's supposed to manage this situation, we figure it out between the counties, and what makes the best sense.

I know Cat comes into contact with those types of situations on occasion, dealing with the hospital, and which jurisdiction the hospital is actually supposed to be a part of, and different long-term care facilities.

But we collaborate and figure that out.

And at the end of the day, the most important thing is that those people are getting served.

- [Steve] Now, when we were talking about access, obviously there's more telehealth going on that existed way even, but I think obviously the pandemic drove people to do more things in an online way.

Is that the future of addressing a lot of this stuff, is to deal with it in a more virtual way than an in-person way, or we're still gonna need the in-person visit, look, touch, see, test kind of thing, versus talk to somebody on a FaceTime call, and say, "Oh, okay, you look okay to me."

I mean, that's simplifying it, obviously.

- [Julie] Sure, we were just talking in a meeting the other day about TB observations, and being able to do that through a virtual call, versus having somebody who potentially has been exposed coming into a public agency.

- [Steve] A public agency, right, right, yeah.

- But then obviously there are other components that we feel much more strongly about that an in-person appointment is preferable.

- Yeah, now with the season that we're in, which obviously we're hearing a lot about respiratory issues which is kind of an ongoing thing, I mean, when you look at that, Cat, are there things you could tell people, say, "Hey, here's the five things "you do to protect yourself."

And then if it gets more detailed than that, specific to a particular disease, but what's the easiest way for us to protect ourselves from respiratory viruses, whether it be the one that's out, whatever the most prevalent one is right now?

- Yeah, the biggest thing with a lot of different respiratory illnesses is just proper hand washing, soap and water.

If you don't have soap and water, hand sanitizer, but that's the big thing.

Don't touch your face because that's how germs can, yeah.

- [Steve] Which is, you know, it's funny because that's as simple as a set of instructions you get, and yet we don't do well at it in a lot of cases, which you'd think by now washing our hands would be kind of a pro forma thing, but it isn't.

So good, and if people wanna find out or have a question about something with public health in Seneca County, you've got a website, you've got social media, there's easily you can get people get in touch with any of you to deal with an issue or question they might have.

- [Julie] Yeah, absolutely.

Our website is just senecahealthdepartment.org, right?

- [Steve] Yeah, yeah.

- [Julie] I had to think for a minute, I don't often have to look at it, but, and you know, we have an administrative page on that website that gives you access to all the different divisions and so you can email whomever you may want to contact or give us a call if you have any questions.

- Great, well, thank you so much for coming in today and talking to us and thank you for all the work you do to keep us healthy, safe, and be ahead of the curve on things that we don't know are coming our way, but you guys are on top of before they get to us.

So we appreciate that very much.

- [Julie] Thank you for having us.

- And you can check us out at wbgu.org, you can watch us every Thursday night at eight o'clock on WBGU-PBS.

We will see you again next time.

Good night and good luck.

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