Someone’s Gotta Do It: While Protecting Their Communities, Local Health Departments Face Rising Caseloads, Dwindling Resources


This article is published in partnership with the National Coalition of STD Directors (NCSD) as part of our joint series on STD Awareness

Imagine. It is 6:30 on a weekday night. The day was tough but the night has promise. You are sitting at home and the telephone rings. It isn’t who you expected to be calling. The person on the other end says “We need to talk. You may have been exposed to an STD.” You pause. Your mind either goes blank or is filled with names, faces, dates. Either way, you know this call isn’t for you; they have the wrong person or the wrong telephone number. But it isn’t you.

But really, it is.

What just happened is a reality for tens of thousands of people every year because they were identified as a sexual partner of someone diagnosed with a sexually transmitted infection. We know why this happens, but how does this happen? Local public health makes it happen. They step in to find, identify, treat and notify people about exposure to an STD for the sole purpose of protecting the community they serve.

Your doctor won’t do it. The hospital won’t do it. The local clinic doesn’t do it. Your boyfriend or girlfriend probably won’t do it. But your local health department will and they do. They will notify you when you have been exposed to a sexually transmitted infection. Public health is thrilled to have the medical community assist by providing appropriate treatment to infected patients and to the clinics and medical offices that are testing for disease. But they are responding to only half of the issue and still, there is another side that has to be addressed – the person who isn’t in the office to test or be treated – the partner. The person who may or may not know they are also infected.

So why does public health take on this challenge? Because without them, endless numbers of people would be exposed to disease and not know it. They in turn will pass the infection along to someone else. So public health departments have a duty, a responsibility and an obligation to stop that speeding train. There may be one, or three, or a whole office to do this job, but despite the numbers, the hurdles and the challenges, they continue to serve in this role. Local public health departments are the community protectors, the people you rarely see and the ones you don’t want to hear from. But when they do call, you know it’s important.

So many local public health departments have faced reductions in staffing, budgets or both that the task at hand is not getting any easier. Many argue that the role is becoming more and more difficult. In fact, the numbers of new infections continue to increase each year, the number of people being infected is also increasing and yet the resources to serve the community are shrinking. However, if the public health community stopped doing its work, then new infections would never decrease and disease would continue to spread. Imagine what the future would be without someone to step in.

Coming from the public health perspective, it isn’t a fun job to notify someone about their exposure to an STD, but it is fulfilling to know that you have helped keep someone healthy. It isn’t glamour or fame that draws us to this role, but the sense of serving and protecting using primary prevention – to prevent disease before it happens, or to promote secondary prevention, i.e. stopping the further transmission of disease. We want to keep the community we live in safe and healthy.

So the next time the phone rings, keep in mind, it may not be the call you want, but it may be the call you get and it will help protect you.

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