One such instance were the “milk wars” that plagued Chicago in the 1890s, when thousands of babies died from drinking bad milk. Due to the product’s long commute from dairy farmers to customers in large cities, combined with unhygienic practices like leaving vats uncovered for sampling and reusing glass bottles without cleaning them, infants routinely died from severe diarrhea, tuberculosis, typhoid fever and other diseases.
Despite the objections of dairies and merchants, various reforms were made over a 30-year period to improve the milk supply. One reform was the establishment of an independently appointed Board of Health, which was willing to make the kind of demands on the powerful dairy industry that Chicago’s elected leaders weren’t.
The Chicago model was emulated across the nation, including Ohio, where state law permits the boards to govern local health districts. Like most other major cities, Cincinnati’s charter calls for an independently appointed board.
Now there’s an effort among some Cincinnati City Council members that could change the traditional structure in which an independently appointed board oversees the city’s Health Department.
Councilman Jeff Berding is leading a push to abolish the local Board of Health and place the Health Department under the control of the city manager, who reports directly to City Council like all other municipal departments. The change is needed, Berding says, because the department hasn’t made enough progress in removing lead paint from Cincinnati’s aging stock of houses and apartments.
Paint containing lead was outlawed in 1978 because studies showed it poses a risk to children when ingested or inhaled. Lead poisoning can stunt growth and possibly trigger diseases as well as cause developmental delays.
But many older buildings still contain paint with lead underneath fresher coats of lead-free paint, especially in low-income areas.
With toddlers prone to eating chips of peeling paint, the potential risk is significant. Statistics indicate that 154,667 of the city’s 165,945 homes built before the paint ban — or 93 percent — likely still contain lead.
In 2006, City Council ordered the Health Department to clean up 302 lead-contaminated properties or prosecute their owners after an award-winning series of articles detailing the problem appeared in The Cincinnati Enquirer. Since that time, 163 of those cases have been handled and closed, according to department records.
That’s not good enough for Berding.
“The Health Department does not report to the city manager, but rather to a part-time volunteer board that meets once a month,” Berding wrote in a guest column for The Enquirer. “Health services are too important to leave to the discretion of a volunteer board that suffers from infrequent meetings and lack of information.”
Berding added, “Putting the Health Department under the city manager, due to the seriousness of the services it provides, would not interject politics but would add a level of accountability missing from an all-volunteer board.”
Board members sharply disagree, noting that City Council has cut the Health Department’s budget and given it limited resources to deal with the widespread problem. Also, council’s request to prosecute unlawful property owners hasn’t been matched by the courts, which have been unwilling to impose jail time on violators.
“Freedom from political influence is essential for developing effective public health policy,” says Dr. Stephen Wilson, the Board of Health’s chairman. “An independent board providing oversight of the Health Department is a critical for protecting the public’s health.
“Councilman Berding contends that eliminating the (board) would provide more accountability. I strongly disagree with this assertion. In fact, the opposite is true. Currently, the Health Department is accountable to the city for its budget and to the (board) for its policies. The (board) is composed of a broad range of volunteers with training in health issues. Collaboration between these two boards could maximize the effectiveness of the Health Department and improve the overall health of our community.”
Board members believe City Council is looking for a scapegoat rather than doing more to solve pressing health problems.
The board points to statistics that show progress has been made since it hired Noble Maseru as health commissioner in 2006. For example, when Maseru was hired there were 302 open cases of lead paint contamination, some dating to 1994, and only two had been prosecuted. Currently, only 139 cases remain open and, of the initial 302, 56 have been sent for prosecution. That’s down from more than 2,000 cases open in 2001.
Meanwhile, the city’s portion of funding for the Health Department has dropped from $22.5 million in 2006 to $19.1 million this year.
The nine-member Board of Health is appointed by City Council based on recommendations from the mayor. The board oversees a department with a $42 million budget and 600 employees; it operates six medical clinics, two dental clinics and several programs.
It would take at least six votes on City Council to abolish the board, and Berding is working privately to shore up support. One person who’s unconvinced so far is Vice Mayor David Crowley.
“The idea whether or not to study it, compare it to other cities and look at what we’ve done right and wrong is worthwhile,” Crowley says. “I’m open to considering it, but I’m not sure (Berding is) doing it in the correct way. He’s using awfully heavy-handed tactics.” ©
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