The Difference between County and State Health Departments (from a Newbie’s Perspective)

By Kayleigh Jennings, APHL/CDC Emerging Infectious Diseases Laboratory Fellow, Florida Bureau of Public Health Laboratories- Tampa

Have you ever wondered why so many health departments exist, what they do, and why there is even a county and state health department separation?  Maybe you haven’t, but I sure have.  Upon arriving at the Florida Department of Health Bureau of Public Health Laboratories in Tampa, Florida to begin my APHL/CDC Emerging Infectious Disease Fellowship (mouthful, I know), I doubted that a state health department would function any differently than a county health department.  Needless to say, I was wrong.

I may not be a veteran in the public health world, but after being immersed in the Florida Department of Health, I learned a thing or two about a thing or two.  Since one of the main goals of the fellowship was to mold public health leaders for the future, I wanted to learn as much as I could about anything related to the health of the population.  After approximately six months at the state department of health, I decided to reach out to the Pinellas County Health Department to grasp exactly how different it was from the Florida Department of Health.

My first sign, as I walked through the doors of the county health department on my first day of the rotation, was a crowd.  Not just a few people, but a crowd of sick individuals sitting in a waiting room.  This waiting room was then followed by another waiting room, and what’s that down yonder…an STD clinic?  Wait…so real people come here?  They don’t just do testing on faceless samples?

After meeting with the appropriate supervisors, I was led down to the clinics where I put on a fancy lab coat, shadowed doctors and nurses, and met with patients all day.  Almost the entire county health department was run like a hospital with nurses running around, staff working way too many hours, and frustrated doctors dealing with noncompliant patients that simply say no to taking their TB medications.  After eight long hours, it was undeniably easy to see that the hardworking individuals at the county health department were in it for their love of helping people.

While at the Pinellas County Health Department, I took every opportunity that I could, whether it was traveling with a supervisor to an HIV clinic, sitting in on a syphilis patient interview, or even watching how the nurses filled out paperwork.  I realized that the county health department was an entirely different realm than the state department of health.  After my rotation, it became very clear to me why both health departments are necessary to the health of the society.

Despite having a deep respect for the staff at the Pinellas County Health Department, I am very happy to have been placed at the Florida Department of Health, because here our samples do not disrespect you or tell you that they will not take their medication.  Important routine testing, and even surge surveillance, is done at the state department of health.  From influenza surveillance to arbovirology surveillance and even rabies testing, they do it all.  Sample after sample, these individuals work as hard as I’ve ever seen to pump out speedy and accurate results so that county health departments, doctors, hospitals, and more health care providers can tell their patients what illness they may or may not have.  The individuals here spend their time effectively and they are all proud to say that they contribute to public health.

After being able to see the differences between the two health departments, I am truly able to value the qualities of each.  I am so grateful to have had the opportunity to work with individuals involved in public health because they are all unique and absolutely captivating in their own way.  The field of public health is not one for the weak of heart, because having a heart is exactly what all of these individuals have.  They thrive on the simple idea of helping others.