Local Boards of Health and Community Health: A Q&A with Ed Schneider
The National Association of Local Boards of Health, which focuses on strengthening and empowering local boards of health through education and training, is holding its annual meeting this week. The theme of this year’s meeting is "Public Health: Effective Governance, Strong Leadership, Engaged Citizens."
NALBOH’s president is Ed Schneider, 70, who was appointed to the Lincoln-Lancaster (Nebraska) County Board of Health in April 2000 and served as president of the board from January 2001 through January 2005. Public health issues addressed during his tenure as president include updating food regulations, addressing environmental issues, implementing tighter animal control ordinances, implementing a new body-art ordinance, and passage of a 100% smoke-free workplace ordinance. NewPublicHealth spoke to Dr. Schneider this week about the contributions local boards of health make to community health.
NewPublicHealth: Can you give us some background on the Lincoln/Lancaster health department?
Ed Schneider: Lincoln and Lancaster County is fortunate in that it has a very advanced health department. It serves a population of about 250-270,000 people and the health department itself has 240 employees. We have a basic budget of about $12 million, and millions of dollars in grants as well. So we’re well-financed, although we have the same fiscal constraints that a lot of departments have throughout the country. We’re lucky that we have the resources that we do. We have a number of departments that do very well, are very, very active. One of them is health promotion outreach—getting out to the public to talk about obesity, smoking, exercising, and preventing diabetes. Then we have the health data and evaluation department and that has one and a half epidemiologists on staff. We have a large environmental health department that works on everything from safety of food to clean water, clean air. The board of health is a policy board that determines policy for this department, and the actual governance of the Department of Health is by the mayor and by the city council and the county commissioners in Lincoln, Nebraska.
NPH: What did the board of health do that has had an impact on community health?
Ed Schneider: In 1999, we did research on how many people were interested in secondhand smoke and smoking in the working environment, and almost nobody was. So we did a great deal of education over the next three or four years and ultimately the county passed a very strong no smoking ordinance in work places. A couple of years later the entire State of Nebraska copied the Lincoln ordinance.
Another success was in land use planning. In this particular case, we worked with the planning commission. We got input from the planning commission, from the contractors, from builders, from public works and from pipeline folks, and the whole idea was to try to increase access to trails, but away from gas pipelines and other toxic materials. The city plan was rewritten to keep toxic exposures away from certain public areas.
NPH: How important have partnerships been to your successes?
Ed Schneider: Very. In the case of the secondhand smoke ordinance, for example, that wasn’t done just by the health department. We worked along with the American Cancer Society, the American Heart Association, the American Lung Association, and the Campaign for Tobacco- Free Kids and we had representatives from the state and local health departments. We would meet on a weekly basis for years to help make the public aware of how important this was and we ultimately passed the ordinance.
NPH: What’s your advice to other boards of health for achieving greater health success?
Ed Schneider: I guess that’s where NALBOH comes in s well as the state associations of local boards of health, who help involve citizens to try to make them strong leaders, and as a result to have effective governance regarding public health. The board of health has the ability to help guide the health department and to go out to the community to share information about public health which the community might not otherwise have.
The board can sometimes be pretty invisible and sometimes we can actually act as a sort of go-between such as helping to take the heat when certain laws pass that are not universally popular, such as our secondhand smoke laws. Our health director at the time was someone that liked to get along with everyone, and we were able to get our strong laws passed by letting him know we’d take any heat.
NPH: What do you think people often don’t know about local boards of health?
Ed Schneider: I think it’s important that people understand that people that are on boards of health come from all walks of life, that they are the representatives of the public. That’s important to remember when you consider that board members give advice on public health policies, what should be emphasized by the health department and how revenues should be allocated so that the community remains healthy.