This is Colleen Bridger.

Public health in North Carolina is suffering from an identity crisis. As your public health director, this concerns me.

Many in the public health profession like to proclaim that public health is a “silent miracle.” The idea behind this proclamation is that when public health is working, everybody is safe and nobody thinks about it. Treating public health like a silent miracle is wonderfully moving, but we need to get real. Health Departments deal with things people don’t want to talk about. We give birth control to teenagers without parental consent because sometimes the teenager is a 13 year-old girl who is being raped by her stepdad and is afraid to tell. We treat the same man month after month for gonorrhea because he refuses to wear condoms. Let’s face it: public health deals with some pretty non-miraculous material.

I prefer this analogy: when my kids were little, they loved a song about a young man who on a rainy day asked old man Mr. Johnson why he didn’t fix his leaking roof. The old man’s reply was “I can’t fix it right now – it’s raining.” The young man then asked him why he didn’t fix it on a bright and sunny day. His reply? “Why would I fix it then? It doesn’t leak when it doesn’t rain.”

To me, this epitomizes the perception of public health.  When we are in the midst of a crisis, public health is seen as a huge government bureaucracy in an irreparable state of disrepair. However, when there is no crisis, there is no attention and no money. The philosophy becomes: why do we need big government? Everything is fine.

In North Carolina, it is a bright and sunny day for public health. Let’s not make the same mistake Mr. Johnson did and put off the maintenance and upkeep public health needs to continue to protect us. When public health’s roof leaks, people die.