SULLIVAN COUNTY, NY — If there’s a genetic marker for health care work, Wendy Brown has it. “My dad and uncle founded the Nyack Ambulance Corps in 1937 with nothing but …
SULLIVAN COUNTY, NY — If there’s a genetic marker for health care work, Wendy Brown has it. “My dad and uncle founded the Nyack Ambulance Corps in 1937 with nothing but determination to help,” she said.
They had watched a friend’s mother die because “there was no way to get her quickly to the hospital.”
Her career has encompassed almost every aspect of health care, from the hard, soul-wearing work in an emergency department to consulting and administration. She’s a registered nurse and does radio broadcasts.
“I remain calm in a crisis and I love being able to help,” she said.
But the truth is, this isn’t a story about Brown. It’s about public health.
Wendy Brown has been the deputy director of Sullivan County Public Health Services for several years now, and she—and the department as a whole—cares deeply about all aspects of the work, the people who are out there doing it and the people who need help.
Here are the numbers: 16 percent of the county’s population lives in poverty. The median individual income is $29,887, according to the Census Bureau. (In the U.S., it’s $31,133 and in New York State it’s $33,562) Our state-wide health ranking is 60 out of 62 counties, and that was an improvement. There’s a long way to go.
It’s complicated by the fact that the county has several strikes against it. “The poverty, the lack of transportation, the lack of education and, on top of all that, the drug issue,” Brown said.
Enter public health. It isn’t just about contagious illness. It also encompasses all those complicating factors and how they affect wellness, disease prevention and treatment. But understanding is improving and approaches are changing. “There have been many leaps and bounds,” in improvement, she said.
Of course, the department has been front and center during the pandemic; communicable diseases (polio, TB, yellow fever) have always been in their wheelhouse and, in the COVID-19 era, that hasn’t changed. Director Nancy McGraw and other members of the department have appeared in legislative meetings, worked with school superintendents, done interviews and far more to spread the word on how we can control transmission. (Not to mention, coordinating the county’s vaccination response.) “It’s all about what people can do to make themselves safe,” Brown said. “We try to get information out there. People need to be educated, but people are scared.”
More information helps. Seeing those who’ve been vaccinated helps.
But there are other epidemics going on.
The state’s Opioid Annual Report in 2019 ranked Sullivan at the top for age-adjusted opioid-related deaths, at 38.4 per 100,000.
Reorganizing the Opioid Task Force was part of the solution. The county spent part of 2020 bringing together groups from all over the county, some of whom hadn’t really had a seat at the table before. Now they have a chance to speak.
Part of the task force, Sullivan County Public Health Services has always worked on reducing substance abuse. In treating it at the public-health level, they “focus on harm reduction,” Brown said, “getting people clean needles, getting them into rehab for substance abuse.” The approach meets people where they are, without judgment, because sometimes, abstinence isn’t feasible.
Law enforcement is an important part of the picture. “We’ve had unwavering support from [them],” Brown said. After all, police are sometimes first on the scene to deal with a problem. Social workers and nurses aren’t always available for this kind of work.
It’s, again, a complicated situation with entangled tentacles everywhere. “Nobody can fix this by themselves,” Brown said.
Home health care
Another aspect of public health, the county’s certified home health agency, has been in the news for several months; if nothing else, it’s drawn attention to a public health function that perhaps didn’t get a lot of notice before.
“I cannot say enough about the calibre of the home health care staff,” she said. Nurses, driving through the county’s back roads to care for people, working in homes where poverty is as much a disease as diabetes, is hard, hard work.
Getting healthy and staying that way
Health education is a big part of public health work. That includes the wellness coordinator, whose job is to spread the word about Lyme disease and other hazards of rural living, and to address sexually transmitted disease (STD). “That’s a major, major issue,” Brown said. STDs such as chlamydia and gonorrhea are listed as increasing on the Mid-Hudson Regional Community Health Assessment. It’s complicated, of course, by the fact that people don’t always reach out for help.
There’s early intervention, too, working with the county’s children to give them the help they need from the start. Last year (pandemic notwithstanding) 420 children were served in early intervention and 395 in pre-K.
And then there are the people behind the scenes. Brown lists them: those who answer phones and calm the angry or scared, those who cope with insurance or Medicaid or Medicare or the state, those who pull together data and write grants, people in other departments who help, and lawmakers at the local, state and national levels. “It’s very much a team approach. None of us could do our jobs without each other.”
There are so many to thank, and the overwhelming impression is that, even though Sullivan County has its share of problems, there are far more people here who are working hard to change the situation—to improve the health of the county. Not just that of individuals, but of the county as a being in itself—one that was ailing but is now, slowly, getting better. As is the way of healing deep-dug disease.
“I’m most gobsmacked by the heart of Sullivan County. People will give you half or more of what they have,” Wendy Brown said. “It’s an honor to live with that.”