The Virginia Department of Health (VDH) has been in existence for over a century. The VDH is a nonprofit government-run health organization, and it is subject to the United States government laws, regulations, and recommendations in addition to those established on a state level. In 1872, the State Board of Health was formed in Virginia, becoming only the third agency in the young nation whose focus was the health of its people. Tuberculosis and malaria prevalence prompted the reorganization of the State Board of Health and the creation of the VDH in 1908; the agency's four employees and annual budget of $40,000 focused efforts on the control and prevention of infectious diseases. Today, the VDH has clinics in every county and city in Virginia. Approximately 150 clinics are located within the 35 health districts in Virginia (Virginia Department of Health, 2009).
The First Half Century
In 1910, laws were established making tuberculosis a "reportable disease." In 1912, the VDH established the Bureau of Vital Statistics to record all births, deaths, marriages, and divorces within the state. The Influenza Pandemic of 1918 saw approximately 500 million people infected, resulting in the death of more than 15,000 residents. The VDH established the Bureau of Tuberculosis Education in 1921; merely a few decades later, mobile clinics traveled the state to provide chest x-rays in the fight against tuberculosis. In1923, venereal disease became reportable by law in an effort to control the spread. In 1928, the VDH created the Bureau of Solid Waste and Vector Control to control solid waste and nuisances such as flies, mosquitoes, and rats to stem disease spread. (Virginia Department of Health, 2008)
In 1930, Mosquito Control Districts were established to control and prevent the spread of malaria. The VDH established the Crippled Children's Bureau and the Maternal and Child Health Bureau in 1935; these programs would eventually spawn programs to detect breast and cervical cancer, reduce infant mortality, and encourage prenatal and perinatal wellness. The 1940s saw the eradication of smallpox in Virginia; establishment of the Bureau of Cancer Control; a state-wide medical examiner system; Office of Chief Medical Examiner; and the Division of Alcohol Studies and Rehabilitation. (Virginia Department of Health, 2008)
The Second Half-Century
In 1954, the Virginia General Assembly began the institution of local health department clinics in all cities and counties and created legislation enabling the cooperation between health departments in each locale, eliminating jurisdiction lines to ensure the same delivery of care; by 1970, all cities and localities were affiliated. In 1960, the VDH initiated the Pap Smear Program and began an anti-smoking campaign in 1964 that eventually gave birth to the current Tobacco Use Control Project. A year later, local VDH clinics began offering family planning services. Childhood immunizations became a requirement for students to enroll in Virginia's public school system in 1972. Two years later, VDH was required to supervise, control, and enforce the federal Safe Drinking Water Act. The Virginia Women, Infants, and Children Program (WIC) was established in 1976, and in 1978 the Division of Alcohol Studies and Rehabilitation was revamped to become the Department of Mental Health, Mental Retardation, and Substance Abuse Services. (Virginia Department of Health, 2008)
In 1979 the VDH became responsible for ensuring all medical facilities were in compliance with federal regulations; today, that responsibility falls on a branch of the VDH: Office of Licensure and Certification. The Virginia Newborn Hearing and Screening Program began in 1986. The VDH established State Child Fatality Review Team and Virginia Vaccines for Children in 1994. The VDH created a Pandemic Influenza Plan in 2002, and in May 2007, the VDH establishing the Pregnancy Risk Assessment Monitoring System in a joint venture with the Centers for Disease Control (CDC) to study the experiences, attitudes, and behavior of pregnant women. In 2008, the VDH facilitated a grant to develop preventative strategies to fight childhood obesity. (Virginia Department of Health, 2008)
Function and Responsibilities
Although the VDH was originally established to fight the spread of tuberculosis, today, it provides many more services. The VDH advocates for safe drinking water, monitors drinking water quality, enforces federal and state standards and regulations, and offers training and education services. The VDH ensures that Virginia is prepared for and responds to emergencies; the VDH has responded to natural disasters, health threats, terrorist attacks, and the need for emergency medical services (Virginia Department of Health, 2008). The VDH Office of Environmental Health Services (OEHS) ensure food, milk, bedding, and upholstery are safe and inspect restaurants and food establishments for compliance to food safety regulations. The OEHS oversees the Childhood Lead Poisoning Prevention Program; onsite sewage and water services; shellfish sanitation, closure, and shoreline surveying; and wastewater engineering. The Epidemiology branch of the VDH oversees regulation reporting, disease investigation and surveillance, immunization programs, disease prevention, radiological health, and environmental epidemiology. The VDH's Office of Family Health Services oversees Virginia Behavioral Risk Factors, pregnancy risk assessment, Division of Child and Adolescent Health, Division of Chronic Disease Prevention and Control, Division of Dental Health, Division of Injury and Violence Prevention, Division of WIC and Community Nutrition Services, and Division of Women's and Infant's Health. (Virginia Department of Health, 2009)
Stakeholders
Many individuals and groups are affected by the actions of the VDH or have an interest in the projects and outcomes produced, both directly and indirectly. One could argue that everyone in the state is affected by the actions of the VDH at some point in time. For the purpose of this paper three specific stakeholder or groups of stakeholders will be discussed: people who drink public water, the (CDC), and school children, teachers, and parents: free H1N1 vaccination to school children.
In September 2009 Giles County residents were deeply affected by the VDH. After a power surge, equipment at the water treatment facility was damaged; this resulted in all county schools being closed for one day until bottled drinking water could be brought in, residents had to boil or buy bottled water for cooking, drinking, and washing dishes; restaurants were limited in the items they could serve-if not closed for the duration, resulting in loss of revenue and an inconvenience to some residents; adults and older children could bathe but were warned to avoid getting water in their mouth or swallowing water; parents were instructed to sponge bathe infants and toddlers; and extra care was needed to prevent potentially contaminated water from entering surgical, deep, or open wounds. (WDBJ7, 2009)
The CDC is a major stakeholder in the actions of the VDH. The CDC relies on the VDH to pass on pertinent information to residents about the control and prevention of diseases, such as the H1N1 virus. The VDH must take the information and statistics provided by the CDC and turn them into meaningful trainings, public education, and provide prevention strategies. One strategy the VDH is taking in conjunction with local school districts is to provide the H1N1 vaccine to school-age children at no cost, in the school setting. This proactive step saves parents money and time, while protecting the students, teachers, school workers, and the general public from the virus. The actions of the VDH are in compliance with the recommendations of the CDC. (New River Valley Health Department, 2009)
Conclusion
The Virginia Department of Health provides a wide variety of services and supports to Virginians in the efforts of making this a healthier state. For over a century, the VDH has been there to provide support through the terrorist attacks on 9-11, anthrax attacks, several hurricanes, flooding, and other natural disasters; the VDH has provided vaccines, education, and support in the fight against diseases. Every single person in Virginia has had his or her life touched in some way by the VDH. The VDH will continue to grow stronger and branch out in the services it provides to Virginians and make monumental steps to make Virginia a healthier state.
References
New River Valley Health Department. (2009). Vaccine information statement: 2009 H1N1 influenza vaccine. Virginia Department of Health.
Virginia Department of Health. (2008). 100 years of tuberculosis treatment in Virginia: Virginia Department of Health recognizes World TB Day and a century of services to Virginians. Virginia Department of Health. Retrieved from http://www.vdh.virginia.gov/100YearAnniversary/index.htm.
Virginia Department of Health. (2009). Local health districts. Virginia Department of Health. Retrieved from http://www.vdh.state.va.us/lhd/.
Virginia Department of Health. (2009). VDH programs. Virginia Department of Health. Retrieved from http://www.vdh.virginia.gov/VDHprograms.htm.
WDBJ. (2009). Giles County residents advised to boil their water. WorldNow and WDBJ7. Retrieved from http://www.wdbj7.com/Global/story.asp?S=11022136.
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