From the startling resurgence of tuberculosis to the modern scourge of environmental hazards, the threats to Salt Lake County's health are growing while prevention and treatment resources are declining.
Dr. Harry L. Gibbons gave that diagnosis to county commissioners and department heads Thursday during a three-hour review of the City-County Health Department's $12.9 million budget.Gibbons, who has directed the department since its inception 22 years ago, said health demands are increasing faster than the department's financial resources.
For example, he said the county last year was confronted by 39 new cases of TB - a 50 percent increase over 1990 - which placed a severe strain on a number of the department's public-health services. "We consider one case an epidemic because where there's one, there are probably dozens," Gibbons said.
The highly infectious disease, which had all but disappeared as a public-health threat in recent years, has been spreading rapidly nationwide mostly among homeless and immigrant populations, he explained. Compounding the problem is the appearance of a drug-resistant strain of TB. Two such cases were treated in the county last year, costing taxpayers about $10,000.
Gibbons said that while TB may be the new "high-profile" health issue, it is only one of many problems facing the department, whose responsibilities include the investigation and control of epidemic, infectious and communicable diseases as well as environmental and occupational health hazards.
John Inch Morgan, director of the health department's administrative services division, provided officials with a statistical analysis of the county's health status, reporting:
- Immunization rates for children have declined by 5 percent since the 1983-84 school year. Almost 10 percent of all children in kindergarten were not adequately immunized in 1990-91.
- The first major outbreak of measles in years occurred last year, with 214 cases reported statewide. Salt Lake County, however, fared better than neighboring counties.
- The number of reported cases of gonorrhea and syphilis have declined substantially during the past five years, but 375 cases of AIDS - and 206 AIDS-related deaths - have been recorded in the county as of Feb. 10.
- In 1990, 620 cases of shigellosis - a type of dysentery - were reported, most of them traced to day-care centers.
- A previous estimate that 30 percent of underground gasoline storage tanks may be leaking has been increased to 60 percent.
- There are 6 million illegally stored waste tires in the county. And since mosquitoes breed roughly 4,000 times faster in tire piles than in forests, those tires could cause a mosquito population explosion. Also, two major tire fires occurred during the past two years.
- Environmental noise has become an "insidious threat to health," contributing to hearing loss and elevated blood pressure. Noise ordinance enforcement, meanwhile, has declined.
- The subject of 2,200 complaints last year, poor sanitation and substandard housing are growing urban problems. In one case, inspectors ordered a house demolished because of unremovable odors and damage left behind by a household that included 80 cats, 30 dogs and two sheep.
- Indiscriminate dumping of hazardous wastes has become a major concern. One landfill worker last year was injured by hydrochloric acid that someone had dumped with the weekly trash.
- Air pollution may be contributing to 50 deaths per year.
Terry Sadler, director of the department's environmental health division, discussed a number of new enforcement proposals that could help alleviate some of the health problems. The possibilities include a diesel inspection and maintenance program, a prohibition against dumping household hazardous materials in the trash, an increase in inspection fees, and creation of an "environmental court" to handle violations and impose fines.
The hazardous-waste prohibition would be accompanied by the establishment of a permanent facility where residents could drop off things like old paint cans, discarded anti-freeze, oil and other pollutants, Sadler said.
County officials said they intend to study all of the department's proposals for possible implementation in future budgets. They also said they intend to find out whether the state is paying its fair share of health costs in the county.