Most people would be satisfied with a "B" grade. It's above average, just a tick below outstanding.
But when it comes to public health, the less-than-ideal score can mean food-borne illnesses, sexually transmitted disease outbreaks and amplified risks on many other fronts.
El Paso County scored its performance this year with a queasy "B." At Monday's annual community meeting on public health, department chief Rosemary Bakes-Martin detailed the county's incapacity to tamp illness in the region a problem, she says, that stems from a lack of funding. The health department, which has endured a $1.1 million slash over the past two years, operates at only half the budget recommended for a community this size.
To date in 2007, there were six communicable disease outbreaks in the county; 84 people suffered gastrointestinal illness, influenza and probable salmonella poisoning. This follows a year in which 919 people fell ill, more than half of them from norovirus incidents at 11 local nursing homes. (The diarrhea-causing microbe spreads from a sick person to food.) Communicable disease episodes (STDs excluded) doubled between 2000 and 2005; the rates reflect the department's "inability to mount an attack," said Bakes-Martin.
While individuals living in group settings like nursing homes, dormitories and day-care centers are at greater risk, Bakes-Martin says the budget crisis has gambled the health of all county residents.
"It is affecting everyone," she said in an interview after Monday's community meeting. "Any outbreak can affect you or I. It is everybody."
STDs are also on the rise. Gonorrhea rates increased 67 percent over the past two years. Chlamydia, which can cause sterility in women, saw a less dramatic jump.
Bakes-Martin, saying the department is short two staff positions to deal with the recent proliferation, called the epidemics a "black eye" on the health department.
Reports of mumps and whooping cough have emerged as well.
The department added about 34 staff members last year, bringing it to 70 employee positions short of the national average.
"We felt we were putting the community at risk," said Bakes-Martin of the decision to add employees. "We were way below where we needed to be."
The community report-card event was the most recent in a string of health department presentations meant to soften county commissioners and the public to a tax increase, which may appear on the ballot this fall.
In addition to state funding and grants, the department receives $4.86 per capita from the county. The statewide average is $11.
If the department doesn't receive increased funding in the future, it could dip into its fund balance to pay for extra staffing. But in 2009, the department is expected to reach a critical point, dipping to 60 days of "cash on hand."
Speaking at the event, Terry Thatcher, president of the local Board of Health, echoed Bakes-Martin's sentiments.
"The next couple of years," she said, "will be critical."