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Q&A: Ed Thompson, State health officer of the Mississippi State Department of Health

Healthy Mississippi

Thompson serving state during challenging times

There are many health issues currently facing Mississippi, and there is one man who knows and maintains the state’s prevention and intervention efforts.  Dr. Ed Thompson, however, seems to handle the responsibility with ease.  The Mississippi Business Journal recently asked Thompson about the state’s most pressing issues, and what the Mississippi State Department of Health is doing to meet these challenges.

Q —  Give us your view on the current healthcare crisis.

A —  I don’t know that you can call it a crisis when it has existed for as long as the problem has in this country. A severe problem is not the same thing as a crisis… a crisis is more a recently developed situation. We didn’t just suddenly come into this situation where we have major problems with our healthcare. The issue is not quality of care. We have some of the finest quality healthcare anywhere in the world. The problem is the cost of it and the affordability of it, the ability of many of our citizens to pay for healthcare, the cost for those of us who do have the means to pay for it and what it costs the system. In some cases, there’s even an issue with access at all. That does not mean that people can expect to live in the most remote corner of some rural area and have a hospital next door to them. People have to realize that choices of where you live and the geography of that choice determine how accessible healthcare is.

In this country, we spend way too much on healthcare and don’t get nearly enough for what we spend. I think that’s been recognized increasingly. Policy makers at the state and national level tend to focus on economic issues rather than on issues like healthcare for its own sake. Healthcare is an economic issue. It affects the cost of business, the availability of a workforce and where a business will locate. When you look at a country that’s about to reach the point of spending 20 percent of its gross domestic product each year on providing healthcare services, that’s a misnomer. It’s not healthcare, its sickness care. We can’t afford to spend one dollar out of every five on healthcare. No other country in the world does that. We’ve got to find a way to get healthcare for everybody who needs it of high quality but at a reasonably sustainable cost.

The other problem with our healthcare system, which has always been present, is that we spend the vast majority, over 90 percent, of what we spend on health in this country on providing clinical care, sickness care.  Less than 5 percent is spent on prevention. So we pay for things that are greater in cost, later on, because we didn’t prevent the problems from the beginning, which is a backwards way of looking at things.

Q —  What are some ways that Mississippi can prevent these problems?

A — Well, I think one of the most important ways is in some our most basic healthcare arenas.  You measure the health of a population.  One of the best, or largest, measures is in the infant mortality rate, and the degree of care provided to infants and mothers, especially low- income persons who don’t have access to healthcare.  How we care for those most vulnerable members of our society says a great deal about the society as a whole.  Mississippi could certainly improve in the arena of maternal and child healthcare. There are many things that we could do to decrease our state’s infant mortality rate, and to improve the likelihood of a healthy childhood for a child born in Mississippi, that’s a matter of willing to spend the money on it. We’ve not been willing to spend that money. One of the greatest things we ever did in this state was to expand Medicaid coverage to women up to 185 percent of poverty if they were pregnant. That sort of thing makes a huge difference, because women can get prenatal care, and their babies can be born healthy.  We need to be doing more finding healthcare available and accessible to everybody in this state, particularly to mothers and to young children who need that kind of care.  There are too many things that we could prevent that we don’t spend the money on.

Q —  What’s the latest on the swine flu?

A —  The absolute latest is the World Health Organization finally designated this as a pandemic.  That’s a terminology issue.  A pandemic is a term that means a worldwide epidemic.  It puts the epidemic of swine flu, H1N1, or novel H1N1, in correct terms.  This is not the same flu as the H1N1 flu virus that is currently circulating.  We can’t call both of these flu strands the same name.  The pandemic designation, for our country and our state, doesn’t mean anything at all because we’ve been acting as though we had a pandemic, and reacting this way for weeks now.  We’re always in a response mode, have been responding appropriately, and will continue to be doing so.  It’s significant in other parts of the world because they will have to step up their efforts, or this is their cue to do so.  For us, we’re already there.  We’ll continue doing what we’re doing. From a practical standpoint, I think it does make it more likely that the Policy makers in Washington are going to appropriate funds for vaccine development and deployment for the pandemic, now that it’s been declared a “pandemic.”  I think that there’s some likelihood that it will have a favorable effect in terms of getting resources applied to it in this country, but directly, no significance to the designation. If you want to know about the current amount of cases of swine flu within our state, go to the Mississippi State Department of Health website, click on swine flu, and the number is there for you.

What we call seasonal flu, the ‘regular’ flu, with three different varieties, two types of influenza A and two types of influenza B, happens every year.  These strands typically prove to be fatal for around 36,000 Americans a year.  We will have a flu season, in the fall, with or without swine flu.  This new strain of flu virus is an influenza A, and will also perhaps be present and circulating.  So far, though, all that we’ve learned about the novel H1N1 indicates that it behaves very much like ordinary seasonal flu.  It’s almost dangerous to use the term “ordinary seasonal flu,” because it is ordinary in the sense that it’s what we see every year, but it’s not to be taken lightly.  Flu can kill you, as we know from the seasonal flu.  We’ve seen deaths from the new swine flu, as well, but it is clinically similar in it’s effects, no more and no less severe than the regular flu that we see. Its pattern of spread seems to be pretty much the same. The method of transmission through the air is the same.  There are some subtle differences.  For reasons we don’t yet understand, the novel H1N1 strain swine flu has been identified more frequently in young people, children and young adults.  That doesn’t mean it’s occurring more often in these people. It just means it’s being identified in them more often.  It may be occurring in other age groups more often, and not being identified as swine flu.  We don’t know the answer to that.  For the first time in 41 years, the world is experiencing an influenza pandemic.

Q —  What’s the latest on the West Nile virus?

A —  There have been no cases of West Nile so far for this year.  Though, it is a fact that we will have cases.  The trouble with West Nile virus, as with most viral diseases, is that you may have cases that don’t get recognized as such.  The symptoms are so varied.  So, we’ve undoubtedly had people who have contracted the virus, but have not shown symptoms, shown mild symptoms, and not gone to the doctor, or have had symptoms, gone to the doctor, and been diagnosed as something else. We see West Nile virus all around Mississippi, through out the year, but mostly during the late summer and early fall.  So we’re coming into the early part of the peak season for West Nile virus.  It is a risk for anyone who is exposed to mosquito bites, and it important to minimize this exposure.

Q —  What’s been your biggest challenge within your department this year?

A —  It kind of depends on how you want to look at that.  The biggest challenge that Mississippi faces in health is infant mortality.  It is a difficult and frustrating public health problem, and continues to be our number one health priority.  Mississippi has seen a rapid decrease in infant mortality in 1960-1980, then a slower decrease in 1980-2000.  We’ve, then, seen it level off.  Now, the numbers have slightly begun to edge upwards, slightly.  We’re not making progress to reducing infant mortality, and of course, we have the highest infant mortality rate in the nation on average.  It’s a difficult problem to address, and it’s the most important problem we have to address.  We have initiated a couple things within Mississippi that I hope may make some progress.  This is an approach targets on those women most likely to have a baby and won’t survive. These children, are born with low birth weight. They account for almost two-thirds of our state’s infant mortality rate. That’s a relatively small number of women bearing babies of that designation.  If we can address those women, if we can identify them when they have their first low birth weight baby, and intervene, so that we may delay the next time they become pregnant until their bodies have time to prepare for the pregnancy, and then be able to identify and stabilize possible health issues such as diabetes, hypertension. Then she has a much lower chance of delivering another low weight baby.

We have two projects now designed to implement this process, whether it is as simple as the logic sounds like it should be.  There is one in the metropolitan Jackson area called the Metropolitan Infant Mortality Elimination project, or MIME, and one in the Delta called the Delta Infant Mortality Elimination project, or DIME. We’re providing those services in these areas on a trial basis and evaluating how well it works. If it works as well as we’ve had some indications from other states, and it might, we will then come before the legislature to present the idea and request for funds. Certain counties have higher infant mortality rates than others. The Mississippi Delta has the highest infant mortality rate depending on a lot of factors.

Q —  Explain a little towards STD research within our state.

A —  Well, this is not a research organization.  Although, we do, in some cases, have projects that do handle some research. We will work in conjunction with the CDC and a couple of our physicians have funded the research projects. But, overall, we’re not a research organization.  We’re mainly a prevention and intervention organization towards STD.  Our biggest advancement remains with syphilis.  Mainly because Mississippi has such a wonderful track record.  In the mid 1990’s, Mississippi had some of the worst syphilis case rates in the nation, the highest over any other state in the nation.  We moved to intervene and apply old fashioned public health techniques, quickly identifying cases, treating them until they are not contagious, identify their contacts, locate and treat them before they become contagious if at all possible. Through our work, the syphilis case rate for Mississippi fell below the National case rate average in 2003.  The first time in recorded history. Unfortunately, it has begun to creep back up.  In 2004 and 2005, syphilis began to edge back up in Mississippi.  We’re now up around the National average.  We’ve got to stop this upward trend.

Age: 62
Hometown: Wesson
Hobbies/Interests: Sailing, reading, music
Favorite Authors: Carl Hiasson, Patrick O’Brien, Mark Twain, Sir Arthur Conan Doyle
Favorite Movies: “Cast a Giant Shadow,” “Patton,” “The Lord of the Rings” trilogy, “Captain Ron”
Favorite Music: Mozart, Vivaldi, Beethoven, Jimmy Buffet, steel drum music, Celtic music

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