Taking
a Chance on health
Lucky
13th for Greg Chance
by Mike
Kroll
It is now hard to believe that establishing a county health
department was so controversial at one time. A group of citizens worked hard to
convince Knox County voters to approve the November 1992 referendum that
created the Knox County Health Department. Five months later, the newly
established Board of Health hired its first employee, Greg Chance. Virtually no
one expected that the Health Department would be involved in so many local
activities or that Chance would remain at its helm 13 years later.
Chance himself credits his parents and upbringing. ÒI think the
fact that IÕm not really an outsider has a lot to do with my success and
longevity here. My family lived near Macomb as I grew up and this familiarity
with the area I think helped me establish relationships early on that were
critical to my successes. I understand that there still remain people in the
community that donÕt understand or appreciate the role of a health department
but those numbers have declined significantly since the referendum was passed.
My staff and I are still striving to convince the remaining doubters through
education and results.Ó
That original referendum permits the Board of Health to levy a
property tax in Knox County to fund the department and the tax has been in
place since the beginning. It has never come close to the maximum rate allowed.
Since its inception, the Health Department has always maintained a property tax
rate below half of the limit. ÒWe have obviously been lucky there,Ó
acknowledges Chance. ÒWe clearly benefited from the better economy at our onset
in the early 1990s and the higher assessed property values, but now we are
obviously in a different era. Grants and other outside funding have always been
our biggest revenue source, but today public health officials like myself are
becoming very concerned about the prospects of greatly reduced state money for
public health programs.Ó
ÒUnfortunately the state of Illinois has lost sight of what our
public priorities should be in terms of public health. While we hear a lot of
rhetoric from Springfield, what concerns me is that for a governor that touts
health care as a cornerstone of his political agenda he fails to appreciate the
appropriate investment of public dollars in prevention. Governor
Blagojevich has failed to deliver
any kind of increase in funding of public health departments since his tenure.
As the current president of the Illinois Local Health Department Association, I
can say that our members are all very disappointed in the GovernorÕs apparent
low priority of public health department funding.Ó
Chance acknowledges that one political reality is that many of the
important prevention areas are political hot potatoes. ÒObviously some areas of
prevention are controversial, such as when we talk about HIV/AIDS or teen
pregnancy or especially sexually transmitted diseases, which remain huge issues
in our community, some members of the community get excited about our
involvement in a less than supportive way. Some people donÕt like to discuss
those things but that is a mistake. I would say, for example, that sexually
transmitted diseases are approaching an epidemic, a problem that is nationwide
in scope and that thrives on lack of understanding. Most people donÕt
appreciate the full impact of sexually transmitted disease financially in terms
of what it costs to treat or the long-term health impacts. The public and
politicians fail to recognize that prevention dollars are the most cost
effective way to address this problem.Ó
ÒMy Board of Health has been willing to take on these
controversial issues but we have been careful to do so in a way that doesnÕt
create roadblocks. We have recognized the potential pitfalls of being too
aggressive and we have identified means of achieving our goals at a slower
pace. Let me use teen pregnancy as an example. When we did our first Healthy
Communities Assessment back in 1994, the statistics said that teen pregnancy
was a huge local problem. We recognized then that the community was not ready
to have an appropriate level of public dialog to address this problem head-on.
So we put it on the back burner and over the next several years we began to
create a public awareness of the issue indirectly through key stakeholders in
the community. By the time we did our second assessment in 1997-98, the
community was ready to begin serious discussion of teen pregnancy and we began
energetic prevention efforts in that regard.Ó
ÒBut sometimes we tend to focus in on these controversial issues
and miss the bigger picture. One of the things we havenÕt done as well at is
marketing our successes. Here I am thinking about testing drinking water,
permitting on-site wastewater disposal, food safety or lead poisoning. Those
are all areas where our department has made significant public health gains and
created little controversy. You can also look at our immunization program or
efforts to encourage smoke-free restaurants across Knox County. In fact, I
credit the food safety inspection program as one of the key reasons the voters
approved creation of the Health Department in 1992. I canÕt tell you how many
food-borne illnesses we have prevented; I canÕt measure that. But I can give you
national data on the number of food-borne illnesses one should expect and Knox
CountyÕs rates are far below that. Now some of that is due to under-reporting
but I believe most of the difference can be credited to our inspection
program.Ó
ÒOne of the things I am most proud of is my departmentÕs success
working in collaboration with elected officials, schools, businesses, social
service agencies, the two hospitals and others to address a range of
health-related issues. I think we have had a positive working relationship the
majority of times and we have always put issues out in front of the public and
not made decisions in a vacuum.Ó
The Knox County Health Department is now an
integrated component in our community. It is almost hard to recall when it
didnÕt exist. And Chance has been at its helm from the beginning. He
acknowledged that he has turned down offers to leave Knox County and even that
other opportunities have passed on him, but he convincingly asserts an
appreciation for this community and the people who work for him. The job has
never failed to challenge Chance who continues to see new challenges foisted
upon his department with little or no new funding accompanying the task.
Whether it be Avian Flu, West Nile Virus, bioterrorism or just plain indigent
health care, all of these problems fall in ChanceÕs lap.