As L.A. County struggles to reinvent the way it provides services to the uninsured, a key factor is preventing illness and accidents to begin with.
That task falls to a number of divisions within the county Department of Health Services covering such areas as sexually transmitted diseases, nutrition, violence prevention and other health threats. And during the summer months, these units tend to be busier than ever.
“Summer is one of the most dangerous times of the year outside of Christmas,” said Maria Iacobo, a spokeswoman for the Los Angeles County Department of Health Services.
The warm-weather months bring with them a whole series of health problems. Besides the risks of food poisoning and heat stroke which can result in death as the body’s temperature-regulating mechanism breaks down soaring temperatures also increase incidences of violence and drowning, as youngsters find themselves on break and unsupervised. And with the National Weather Service predicting unusually warm temperatures this season, public health officials say people should exercise extra caution.
More than 170,000 cases of food-borne illnesses occur each year, nearly half of them during the summer. Health officials spend a good deal of time and effort trying to educate people to keep food refrigerated to avoid problems.
“There’s a high risk of growing enough bacteria to create illness,” said Dr. Roshan Reporter, a county medical epidemiologist.
Syphilis out, chlamydia in
On the disease front, county health officials over the past few months have been struggling to get the word out about a major syphilis epidemic that gripped L.A. starting in March, particularly within the gay community. Dr. Shirley Fannin, director of the county’s disease control program, said that threat has largely abated. While there were 90 cases from mid-March through June 2, only eight new cases were reported from June 2 through July 5.
To fight the syphilis outbreak, the county launched a radio advertising and billboard campaign that will continue for the next three to six months. It also sought out the sex partners of infected persons for testing and treatment, and embarked on a screening effort that included county jails.
“The cases occurred in a part of the population with a high number of anonymous partners,” Fannin said.
But there are still plenty of sexually transmitted diseases to worry about. Currently, chlamydia which if untreated can cause sterility is the single most commonly reported sexually transmitted disease in the county, Fannin said.
The highest risk group for this disease is adolescents with multiple sex partners. County health officials are testing and treating those living at juvenile residential facilities and encouraging tests at school clinics. There has also been an emphasis on treating the sex partners of diagnosed cases, Fannin said.
Meanwhile, there has been a “slight upswing” in the number of newly diagnosed HIV cases countywide in the past few years. Since 1987, there had been a slowing of the epidemic until now. “People have gotten tired of changing their behavior,” Fannin said.
County health officials are looking nervously north toward San Francisco, which is seeing a definite upswing in the HIV rate.
While AIDS has resulted in more than 25,000 deaths in Los Angeles County since 1981, the introduction of protease inhibitors and new combination therapies have led to a nearly 80 percent decrease in deaths from the disease from 1993 through 1999. And while it started as an epidemic among gay white males, it has spread to intravenous drug users, minorities and women.
There’s also danger from high bacteria levels in the ocean, which poses the risk of respiratory infections or diarrhea to swimmers. A new feature on the county’s public health Web site (www.lapublichealth.org) is meant to help Angelenos determine whether it’s safe to take a dip. People can also get water quality information by calling the county’s 24-hour beach hotline.
Dangers of heat
When the temperature exceeds 100 degrees, so does the risk of heat exhaustion and finally heat stroke. Those most vulnerable include the elderly, children and those with chronic ailments including arthritis, kidney disease or congestive heart failure, according to Dr. James Haughton, the county’s medical director of public health.
Heat exhaustion is caused by insufficient water and salt intake and a lack of sweat, which helps to cool the body. Symptoms include headaches, pale and clammy skin, and a rapid and weak pulse.
Heat stroke occurs when the body becomes overheated and can’t regulate its temperature. Symptoms include rapid heartbeat, dry and flushed skin, no perspiration, confusion and loss of consciousness.
With kids out from school, the risks escalate for drowning, accidental shootings and other types of violence, according to Billie Weiss, county director of injury and violence prevention.
Even though the number of drownings has decreased by more than 50 percent in the past five years due to increased awareness and a new law requiring barrier fencing around pools older pools are not covered by the law.
And as temperatures rise, so do injuries from violence between young people who are unsupervised while their parents are working, Weiss said.
“Neighborhoods that need it the most have the fewest programs,” said Weiss. “Maybe it’s time for businesses to outreach into the communities where they’re located, releasing employees for mentoring time.”
