Health care reform and the role of public health agencies.

Experience in developing a local public health program, covering a period of approximately 45 years, is described. Included are the assessment and analysis of problems, policy formulation, plan development, and program implementation. A study of problems of seasonal farm workers, particularly those who migrate, is described, as well as a health services delivery program based on this study. Attention is given to incorporation of medical care with core public health services, and the use of a multidisciplinary team. Special features required to overcome cultural, language, educational, and other barriers are outlined. Adaption of knowledge gained from the migrant health project toward meeting needs of the county's medically underserved population is described. Involvement of the community, including representatives of private and public sectors, in the development and implementation of plans is emphasized. Maintaining appropriate emphasis on preventive aspects is discussed, together with mobilization of financial and other support. The importance of qualified public health staff is also emphasized: residency programs for physicians and dentists and training for other personnel are described.

History of local public health in Florida.

An attempt has been made to highlight salient features in the development of public health services in Florida. In order to place local public health in proper perspective, a brief review of the development nationally, and at the state level is given. Changes in public health problems and programs designed to address them are described.

Outbreak of illness due to volatilized asphalt coming from a malfunctioning fluorescent lighting fixture.

We investigated an outbreak of headache, eye irritation, sore throat, nasal congestion, and nausea in an office complex, ongoing for three months and regularly resolved upon leaving the building. Investigation suggested that the etiology of the illness was malfunctioning fluorescent light ballasts , which overheated and resulted in melting and volatilization of contained asphalt . Correction of the problem resulted in almost complete disappearance of symptoms within two weeks.

Prevalence of hepatitis B surface antigen among women receiving prenatal care at the Palm Beach County Health Department.

Pregnant women receiving prenatal care at the maternity clinics of the Palm Beach County Health Department were tested for hepatitis B surface antigen. Routine screening of pregnant women for the antigen is discussed. The results of this study indicate the need for routine screening of our medically indigent pregnant population.

Two successive outbreaks of Clostridium perfringens at a state correctional institution.

An outbreak of acute gastrointestinal illness of short duration involving 100 inmates at a correctional institution followed a similar outbreak among the same population by eight days. Clostridium perfringens was the specific etiology in both outbreaks; the vehicle was roast beef in the first outbreak, ham in the second. Direct observation of food handling practices revealed that the meats were not cooled quickly enough following cooking; not reheated adequately prior to serving, and; held at improper temperatures prior to serving.