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Curious Iowa: What do county health departments do?
Jan. 27, 2025 5:30 am, Updated: Jan. 27, 2025 8:08 am
And how do they combat misinformation and disinformation?
The Gazette offers audio versions of articles using Instaread. Some words may be mispronounced.
What exactly does a county public health department do? That’s what Cindy J. Dvorak of Cedar Rapids asked Curious Iowa to investigate. Curious Iowa is a series from The Gazette that answers readers’ questions about our state and how it works.
“Many people don’t even know the public health [department] exists in their community.” Linn County Public Health Director Pramod Dwivedi said. “I say that the food that you eat, the water that you drink, the air that you breathe is safe because of the work that we do, and often we do our work behind the scenes.”
From inspecting restaurants and private well water, to monitoring air quality and educating the public on healthy behaviors, county health departments are made up of public servants who work every day to keep you and your neighbors healthy.
What areas do county health departments oversee?
“We kind of jokingly say that if you’ve seen one health department, you’ve seen one health department,” Danielle Pettit-Majewski, director of Johnson County Public Health, told The Gazette.
The services health departments provide vary, but community health, clinical services, environmental health, mental health services and emergency preparedness are common areas health departments work across. Offerings of health departments are based on the community’s size and needs, in addition to factors like capacity and funding.
For example, Linn County is the only health department in the state that has its own air quality program. That program monitors and tracks air quality in real time through monitoring stations throughout the community. Dwivedi said that it was important for Linn County to monitor pollutants in the air due to the amount of industries in the county.
Another example is that Linn County Public Health’s branch of environmental quality is responsible for inspecting all tattoo and tanning facilities in Linn County. They also have contracts through the state Department of Inspections, Appeals and Licensing to inspect tattoo, tanning and aquatic facilities in Jones County.
Dustin Hinrichs, environmental quality branch manager at Linn County Public Health, said it is “fairly common” for local programs to partner with neighboring counties if those counties are unable to do the inspection work themselves.
Linn and Johnson counties have clinics where residents can go for services relating to sexually transmitted infections, tuberculosis and vaccinations. In 2024, Linn County introduced a mobile health clinic that would improve citizens’ access to services. So far, it has been used at local schools and community events for athlete physicals and immunizations.
Taking another step back, public health departments work on everything from assessing and monitoring population health and investigating and addressing health hazards and root causes, to strengthening community partnerships and working on policies, plans and laws.
“Public health does not have the capacity to solve all of the problems, but we are excellent conveners and bringing partners to the table because so many problems that impact health outcomes are impacted because of a very wide variety of issues, and it takes a lot of political will to make those changes.” Pettit-Majewski said.
County health departments use community health assessments to take a temperature reading on community needs. These surveys go out every five years.
Pettit-Majewski said that in Johnson County, priorities are food security, access to care, dental and housing.
In Linn County, Dwivedi said priorities are mental health, food security, equitable opportunities for physical activity and gun violence prevention.
How do county health departments share information and combat misinformation, disinformation?
There are a variety of ways county health departments inform and educate the public. For example, health educators go into schools to teach students about the dangers of tobacco use. Targeted ads are put in newspapers, on TV or social media platforms, and information is translated into multiple languages.
Pettit-Majewski said the goal of these efforts is to “demystify” the science and make it easy for people to understand. For example, she said that the immunization rates for the seasonal flu are “abysmal,” “like 10 percent for kids 7 and under, like 16 percent for seven to 19.”
“We recently just did a video that actually got picked up by Newsweek, where we are talking about … the importance of getting a vaccine for seasonal flu and preventing an outbreak of H5N1 (bird flu), and we used very simple graphics,” Pettit-Majewski said.
According to the most recent data from the state, 34.9 percent of Linn County residents have received the flu vaccine this season, down from 38.1 percent the previous year. In Johnson County, 39.8 percent of residents have been vaccinated against the flu, compared to 42.5 the year before.
She acknowledged the misinformation and disinformation public health departments across the country are combating.
“Most of us, we don’t have a lot of institutional memory about life before childhood immunizations, but what we have are our cemeteries filled with small children who did not live to see their first birthday because we didn’t have them, and then after the ‘60s, that kind of stopped,” Pettit-Majewski said. “But that doesn’t mean that’s a problem we don’t have to continue to fight, because it will re-emerge if we let it.”
She said communities aren’t prepared for a re-emergence of infectious diseases like measles or polio.
"It’s a huge concern to be kind of fighting battles that we’ve already won that were considered great achievements of the 20th century, but there’s not that institutional memory that a lot of folks have around what life was like before.“
Dwivedi said that they are still struggling with fallout of COVID-19, where “misinformation and disinformation prevailed and science and data took the back seat.”
“Our job is really to provide the information and let people know that this is for their benefit,” Dwivedi said. “There is no vested interest on our part.”
How can Iowans participate in public health?
Beyond completing your county’s community health assessment and taking care of your physical health, you can play a role in protecting the health of your community in a variety of ways.
The environmental safety branch of Linn County Public Health oversees the food safety, aquatic safety, tattoo and tanning and water wells and septic programs. Linn County is responsible for inspecting more than 1,500 food facilities, 50 tattoo facilities, 89 pools or spas, and 23 tanning facilities.
Linn County inspects food facilities at the retail level. The state of Iowa and the U.S. Food and Drug Administration are responsible for manufacturing facilities.
Tattoo, tanning and aquatic facilities are inspected at least once annually. The frequency of inspections for food facilities varies. Several factors are used to give the facility a risk number, which determines how frequently the facility is visited.
“We look at the type of food that a facility is preparing, the clientele that they serve, their hours of operation, the volume of the food, and we assign them with what we call our risk number,” Hinrichs said.
A risk 1 facility in Linn County may be inspected every three to five years, whereas a risk 5 facility will be inspected at least twice a year. Hinrichs said Hy-Vee stores are examples of a risk 5 site.
“Obviously both from a volume standpoint, retail sales, then they’re also preparing a lot of foods on site, so the complexity of what they’re doing is a little more complicated.” Hinrichs said. “They also prepare sushi on site.”
An example of a risk 1 site would be a vending machine, where unpackaged food is not being handled.
School kitchens are inspected at least once a year.
Hinrichs said Iowa has a robust complaint system for restaurants, and tanning, tattoo and aquatic facilities. Iowans can protect public health by bringing concerns forward.
“If you see something, maybe bring it up to the management staff at a facility because likely they are not aware of it,” Hinrichs said. “If you don’t get a great response from management, that’s when we would ask that you maybe elevate it and bring it to our attention so we have a look into whatever your safety concern might be, whatever your public health concern might be.”
On the water wells and septic side of things, Hinrichs said he’s seen a deficiency in rural homeowners and business owners understanding how septic systems and wells function.
“Septic systems need maintenance ... if your septic system has a tank, the tank needs to be emptied out periodically, and at that time, you can hire an actual septic contractor to come out and take a look at the tank and see if they can identify any issues that you might have in the septic system on site,” Hinrichs said.
Additionally, he recommends annual water testing for well owners to ensure the water source on the property is safe.
“I just want people to realize that the work that we do here is for a very good reason. A lot of unfortunate, bad things happened historically to lead to us creating the systems that we have now to ensure that we have safe water, safe air, safe food, that we can go swimming in a safe pool, that if we choose to get a tattoo, it’s done so safely and sanitarily.” Hinrichs said.
Both Dwivedi and Pettit-Majewski said that public health departments are a “no wrong door,” meaning that if they are unable to answer your question, they’ll get you to someone who can.
“We do ... gap filling here because even though that was not the intended goal of public health, we do a lot of gap filling,” Pettit-Majewski said. “My partners across the state, we all are trying to fill the gaps of the boats that we’re pouring buckets out of, because we know that that’s what our communities need, and so that’s what we’re going to continue to do, is pivot and try to meet the needs of the community.”
Contact Linn and Johnson County Health Departments
Linn County Public Health
- 1020 Sixth St. SE Cedar Rapids
- 319-892-6093
- linncountyiowa.gov/health
Johnson County Public Health Department
- 855 S. Dubuque St., #113, Iowa City
- 319-356-6040
- johnsoncountyiowa.gov/department-of-public-health
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