The State of Michigan’s public health system recently celebrated its sesquicentennial: 150 years in service to Michiganders. To mark the occasion, the Michigan Department of Health and Human Services (MDHHS) has shared a nice collection of sesquicentennial information on its website.   

The first department of public health in Michigan was established in July 1873. A system that encompasses federal, state and local organizations, public health protects residents from unsafe conditions, prevents disease, and promotes good health.  

First known as the Michigan Department of Public Health, the MDHHS released a report “The First 100 Years” to celebrate its first century in 1973. During a conference that year, recommendations for improving the department’s service to Michigan’s residents were developed. These recommendations included “coordination of regulation of institutional providers” due to healthcare delivery becoming increasingly complex and expensive; “encouragement of innovative delivery systems” to ensure that all Michigan residents have the ability to make well-informed decisions regarding healthcare; and “encouraging community involvement” to ensure that public healthcare organizations were operated by individuals who understand the needs of the communities they served.

In 1895, Michigan passed a law requiring schools to teach about communicable diseases.
A timeline on the MDHHS website highlights the past 50 years, sharing about everything from Pontiac Fever in the ‘60s and PBBs in the ‘70s to the “Eat Safe Fish” program of the ‘80s and  funding HIV care centers in the 90s. Since then, the MDHHS has tackled SARS, terrorist threats, newborn screening, PFAs, and COVID-19, to name a few.

Despite facing a number of challenges, particularly and most recently the COVID-19 pandemic, the MDHHS has developed life-saving vaccinations, improved standards surrounding water and food safety, and increased overall life expectancy in Michigan by 30 years. How did the state of public health in Michigan get to where it is now?
Norm Hess.
Michigan Association for Local Public Health (MALPH) executive director Norm Hess shares how in his recent MDHHS op-ed “Celebrating Community Health,” as part of the MDHHS Sesquicentennial website. When Michigan’s Department of Public Health was founded, state residents were dying from illnesses like typhoid fever, tuberculosis, polio, and diphtheria along with waterborne illnesses from unsafe drinking water at very young ages, and at an alarming rate.

“In 1921, Michigan had the highest death rate from diphtheria in the world,” writes Hess. “Dr. Clifford Young built the first laboratory on state property to address the disease. By 1940, Michigan cut its diphtheria death rate from 1,200 per year to less than 40.”

Hess also writes that the development of both a state health department and Board of Health was crucial to “identifying and addressing widespread issues to prolong our lives and improve their quality,” whether that be through the development of vaccines, such as when Michigan developed whooping cough vaccine in 1940, passing state laws to better manage water systems and sewage treatment in construction projects in the 1930s, and now by educating communities on disease identification, treatment, and prevention.
State of Michigan public health messaging from 1924.
“Local and state health have a storied history of bringing great minds to big challenges,” he writes. “On behalf of local public health officers around the state, we look forward to working together with the Michigan Department of Health and Human Services to continue to address current challenges and any the future brings so we can achieve another 150 years of success in leading and establishing programs that protect, prolong and improve human life in every community.”

In “The First 100 Years,” former MDHHS assistant to director Lois Lamond noted that the state’s public health program was “designed to be low-keyed, but when I look around I see it’s going to be very high-powered.”
State of Michigan public health messaging from 1924.
It’s clear that MDHHS and public health in Michigan in general is no longer low-key, as it is more present than ever in a post-COVID society, and high-powered. Forty-five local health departments across the state implement new programs that follow state-mandated regulations and directly meet the needs of residents.

When looking at public health in Michigan today, fifty years later, it’s clear that these recommendations were implemented by the way MDHHS operates now. In addition, organizations like MALPH help health departments across the state to both communicate with one another more easily and communicate their needs at the state legislative level more effectively so they have the tools and resources needed to best serve their communities.

While proud of its 150-year history, change is on the minds of those at MDHHS, who are looking at the post-COVID world as an opportunity to improve health communication to the public as well as readiness in the event of another health emergency like COVID. MDHHS public information officer Lynn Sutfin says that areas currently targeted for improvement include bolstering the public health infrastructure, modernizing IT systems, and partnering in local communities.

“It is important to have ongoing, two-way communication,” Sutfin says. “The pandemic resulted in increased frequency on how information needed to be adapted and released due to rapid changes in what was learned about COVID-19.”

Public health has many faces in Ingham County: Lauren Chambers, behavioral health consultant; Laura Scurlock, NP; Kajalpreet Kauer, RN. Bottom row, l-r: Sterling Wendt, community health worker; Donna Korganji, NP; Dr. Alane Laws-Barker, gynecologist/surgeon.
Local health departments: A history of meeting community needs

Michigan’s local health departments collaborate with other organizations in their communities such as schools, law enforcement, and health care providers in order to disseminate information to the largest possible audience, meet communities where they’re at, and ensure their health needs are met. 

One of Michigan’s oldest public health agencies, the Ingham County Health Department (ICHD) recently celebrated 85 years in service. ICHD’s medical health officer Dr. Adenike Shoyinka stepped into her role five years ago. She says that ICHD is committed to both its state-mandated responsibilities and health equity.
Dr. Nike Shayinka.
“There’s been an interesting shift where we don’t just talk about disease monitoring and vaccines,” says Shoyinka. “We’re also talking about social determinants of health and how those affect how we can improve the quality of life for individuals and reduce human suffering.”

ICHD has also focused more on issues like substance use disorder (SUD) and gun violence within the last several years as well as the stigma which surrounds them. Shoyinka says that in order to more directly address these issues, ICHD works closely with grassroots nonprofit organizations and community groups to help implement more programming and services around these and other issues.

“We are recognizing at multiple levels how to better communicate with our residents,” Shoyinka says. “We are working with Advance Peace Lansing in order to develop our own program to prevent retaliatory and gang-related gun violence, and we are working on an opioid spike alert system to communicate to the public if there’s been an increase in cases of overdose presented in hospitals, and why we are experiencing that spike.”

For those impacted by SUD, ICHD promotes harm reduction programs and adopts language to better communicate to county residents. Twelve Naloxone (Narcan) vending machines set up throughout the county provide the public free access to the easy-to-use drug, which can reverse opioid overdose. 

Another shift in public health, Shoyinka mentions that she and other public health officers have had to look at and develop their workforce. Particularly after the pandemic, public health along with many other industries has suffered a much higher turnover rate, making it difficult to implement some programs in effective ways. Turnover has also impacted the relationships ICHD has with local collaborating organizations. Shoyinka says that despite these difficulties, she and her team are learning how to provide the community the information and services that they need.

“We’re recognizing that it’s not that we just need bodies, we need trained bodies who have leadership qualities and skills to do whatever it is in that public health space to deliver on our mission,” says Shoyinka. “We are learning, as an organization and industry, that we can’t do that work alone. We need input from the community we serve.”

Staff from the Cedar Community Health Center-Women’s Health, a part of the Ingham Community Health Centers and Ingham County Health Department.
Working directly with the community more and improving the perception of public health are among Shoyinka’s goals for the future of ICHD and public health in Michigan. Prior to COVID-19, few people were aware of the extent of the work public health does for a community. While the newfound knowledge and visibility has helped in terms of disseminating information to the public more efficiently, Shoyinka feels that not everyone trusts public health entities or understands how the work public health does helps the overall community. 

“As a local public health department, we are at the center of this ecosystem that I call a strong public health infrastructure,” she says. “Externally, we have a goal of integrating our services across our organization and community and strengthening our partnerships. That’s critical to this next post-COVID, new-normal phase.”

While Shoyinka sees ICHD as an organization that is continuously growing and evolving, she hopes that the future of public health will continue to improve in the post-COVID world and that trust in public health institutions will grow with time.

“As a health officer, I can come out and say things to the media, but we realize that there is so much more that needs to happen in that space of communication,” she says. “We can’t get what we don’t have if we aren’t growing.”

Rylee Barnsdale is a Michigan native and longtime Washtenaw County resident. She wants to use her journalistic experience from her time at Eastern Michigan University writing for the Eastern Echo to tell the stories of Washtenaw County residents that need to be heard.

Photos of ICHD by Doug Coombe. 
Historical photos courtesy MDHHS.
Norm Hess photo courtesy MALPH.

The Yours, Mine, and Ours — Public Health series highlights how our state's  public health agencies keep us healthy, safe, and informed about issues impacting physical and mental health in our communities, homes, workplaces, and schools. The series is made possible with funding from the Michigan Association for Local Public Health.