How many advanced degrees does it take to solve a health carecrisis?
Dr. Anthony Iton -- Alameda County's new health officer -- hasthree.
He's got an M.D. from Johns Hopkins Medical School in internal andpreventative medicine. And he earned both a law degree and a master'sin public health from University of California, Berkeley.
County officials hope Iton can parlay his impressive credentialsinto helping solve entrenched problems here -- such chronic ailmentsas diabetes and hypertension, high rates of HIV/AIDS among AfricanAmericans and emerging
infectious diseases on the horizon, such as West Nile Virus.
Then there's the bigger problem of growing numbers of theuninsured, and how to better the health of so many people strugglingwith the basics -- finding a job and affordable housing, feedingtheir families, avoiding crime and getting their kids through theschool system.
'I liken it to walking into a community, and there are firesburning,' Iton said in an interview.'You can't start selling peoplefire insurance and sprinklers. They're on fire! You've got to put outthe fires before they can hear you.'
Last month, the county managed to woo Iton back to the Bay Areaafter a five-year stint as health director for Stamford, Conn., acity of 117,000. He follows interim officer Dr. Robert Benjamin, whowill retain his position as director of the county's tuberculosisprogram.
In his new job, Iton is charged with overseeing the health of 1.4million people in 14 cities. Berkeley is the only city in the countywith its own public health officer.
The 40-year-old Iton will manage everything from federal and statefunds for HIV/AIDS programs to childhood asthma initiatives to makingsure restaurants and prisons are abiding by health codes.
Dave Kears, director of the county's Department of Health CareServices, said Iton's experience as both a clinician andadministrator is much in demand.
'We have a hell of a lot of problems,' Kears said. 'He can help usfigure out how to maintain clinical integrity with diminishedresources. We need him more today than ever.'
Iton hopes to nudge the county -- and its residents -- to 'takeownership' of its problems, such as a $45.7 million deficit at thecounty's medical center. The center treats a rising number ofpatients who have no means to pay for care, and recently closed twooutpatient clinics and is considering shutting the trauma center atHighland Hospital in Oakland.
'You have to accept the fact that the resources you have are allyou are ever going to have to address the problems,' Iton said. 'It'snot going to get any better than this.'
His major focus is children. While in Stamford, Iton workedclosely with that city's school superintendent to ban sodas fromelementary and middle schools, get the locker room showers workingagain so kids could get a good workout in gym class, and reform theschool lunch program to offer balanced meals beyond endless plates offrench fries.
He also used schools as a way to sign up uninsured children forConnecticut's child health program. Despite a massive ad campaign,many parents, especially new immigrants, were reluctant to enrolltheir children. By hiring someone to go into the schools and workwith nurses and principals, hundreds of kids were insured, he said.
Also through the schools, the health department pinpointed whichkids had asthma and then got permission from parents to participatein house allergen consultations on asthma triggers such as molds anddust. Using federal funds, the health department provided freehypoallergenic pillows and air filters, and made sure landlordssolved mold problems.
'This isn't rocket science,' he said. 'It's not like kids are outthere somewhere and we don't know how to find them. They're rightthere at the schools.'
Despite the challenge of coordinating with 17 schoolsuperintendents here in Alameda County instead of just one inStamford, Iton said he plans to work closely with schools on similarinitiatives.
'At the county level you are one step removed,' Iton said. 'AtStamford, I could walk over to the superintendent's office and saylook, this is what I want to do and here's why and how.'
Iton has started a few firestorms of his own. While at Stamford,he was criticized for spraying insecticides to slow the spread ofWest Nile Virus. Counties typically spray less harmful so-calledlarvicides to kill mosquito larvae, but spraying pesticides that killadult mosquitoes is less common.
Iton said he felt the spraying was warranted -- considering thatthree people come down with encephalitis from the West Nile Virus.
'Spraying was something we did very reluctantly in the context ofhuman exposures,' he said.
Alameda County's Mosquito Abatement District doesn't normallyspray insecticides, but officials there said they would consider itif West Nile Virus emerged in the region.
Iton also fell into the hurricane's eye of the 2001 anthraxattacks, when a 94-year-old Connecticut woman died from exposure to acontaminated letter sent through the mail.
While Iton doesn't take such crises lightly, he said 'scaretactics from Washington' are distracting local public healthofficials from their core mission of improving the overall health ofthe county.
How does a health department juggle multiple emergencies amidlimited resources?
'The reality is that since bioterrorism came along, there's been arenewed interest in public health infrastructure,' he said. 'Yes, westill have a weak infrastructure. Shoring it up is one of my keygoals.'
Contact Rebecca Vesely at rvesely@angnewspapers.com .
