Lancaster, PA (October 26, 2007) - This is one of those columns I hope out-of-towners don't read.

That's because I don't want visitors and potential newcomers attracted by Lancaster County's economic opportunities, scenic beauty or small-town values to find out the county doesn't operate a public health department. But there it is.

We have about a half-million residents but no agency with a mission of keeping us healthy through comprehensive prevention.

I don't want out-of-towners to know, for instance, how spotty restaurant inspections are (outside of the city) because we leave that task to the state.

I don't want them to know small-scale food vendors, such as chicken barbecue stand holders, often go unchecked.

I don't want them to know how groundwater is threatened by inconsistent inspection of on-lot treatment of human waste.

I don't want them to know how hit-and-miss our efforts are in dealing with threats ranging from West Nile virus and lead paint poisoning to unimmunized children and the spread of HIV.

Who's accountable?

I wonder what out-of-towners would think if they knew the mortality rate for children ages 1 to 4 is 50 percent higher in Lancaster County than in Pennsylvania as a whole.

Why are preschoolers dying? What are we doing about it?

If we had a director of public health, we'd expect that person to figure out what to do. A health chief would also be looking at other health indicators where Lancaster County lags and would be charting corrective courses.

But right now there is no person accountable to the public on issues of health and safety. That's the bad news we don't include in our marketing efforts to out-of-towners.

Earlier this year, the news was even more discouraging for those who support the United Way-led effort to create a county health department and bring Lancaster County into the 21st century. Republican voters in the May primary nominated for county commissioner Scott Martin and Dennis Stuckey, who in a forum in the spring turned thumbs down on a health department.

"I believe this would be a tremendous mistake," Martin said before the primary. "Your pocketbooks are the ones that are eventually going to feel it."

Stuckey called a health department "just another level of bureaucracy" that would result in inspectors telling property owners to fix leaky on-lot sewers.

Oh, horrors!

Small investment

Perhaps they have started to educate themselves about Lancaster County's unmet public health needs. If that's the case, they are better candidates than I thought.

Nevertheless, both candidates at a fall forum, as they did in the spring, expressed a greater concern for saving money than for safeguarding the people's health and safety.

So let's talk money. The 22-member Partnership for a Lancaster County Public Health Department — members include all four hospitals and Lancaster County Business Group on Health — projects a $1.5 million budget for an 18-employee department. State grants would cover 90 percent of the cost. The impact on the county budget: $150,000.

That small investment would open the door to federal grants — for services such as lead paint abatement and chronic disease management — for which only health departments can apply. The partnership's Hilda Shirk tells me counties with health departments are getting competitive federal grants totaling $250,000.

Those dollars likely are going to communities where our visitors live. And that's something the visitors probably don't want us in Lancaster County to read.