It’s been a tumultuous year at the St. Joseph County Health Department, but Dr. Diana Purushotham wants to focus on moving forward.
After all, as the county’s new health officer, she has just three months to get her department ready for a growth spurt.
Under the Health First Indiana initiative pushed by Gov. Eric Holcomb and approved this year by state lawmakers, the state will send $225 million in new money to counties over the next two years for public health. It’s an effort to pull Indiana up from the bottom of national rankings on public health spending and clinical health outcomes.
When Purushotham says she wants to move forward, she means she doesn’t want to dwell on the tension that filled the air at some county council and health board meetings earlier this year, before her arrival. In June eight key health department staff members quit, citing what they said was undue political interference with their jobs by some of the new Republican council members, conservatives who were still angry with the health department for enacting mask mandates and administering a vaccine clinic during the COVID-19 pandemic.
The department had taken those measures under the leadership of Dr. Bob Einterz, who quit in March after he said he could no longer work with Republican council members and commissioners.
Purushotham, a native of Toronto, came to the area in 2019 to follow her husband’s career. He is Dr. Anatoliy Rudin, an endocrine and general surgeon. They met in medical school in Chicago and also worked at Mayo Clinic and Cleveland Clinic together.
They live in Granger and have two children, ages 10 and 6.
Purushotham says the department is trying to fill the jobs of those who quit this summer, and it will have to hire more people next year gradually as needs arise in the expansion.
The Republican council members have delayed approval of some grants that the health department has sought from nonprofits and the state and federal governments because they include the term “equity” in their titles. Republican Council Member Dan Schaetzle has argued the term doesn’t belong in public health because it can’t be quantified or measured. Amy Drake, another of the new Republicans on the council, has gone so far as to call the term “equity” used in this context “Marxist.”
But those who have quit the department have said equity simply means striving to give everyone equal access to high-quality health care, since the poor and people of color on average suffer worse health outcomes.
Purushotham says she is not interested in rekindling such controversies, nor does she want to comment on them since they happened before she was hired. She wants to focus on moving ahead.
“Trying to find that middle line and doing a majority of the work with collaboration is going to be my approach because I think health and health care and access to health, those are some common basic things that almost everyone agrees on,” Purshotham said.
Purshotham said she will work to find common ground between people on both ends of the political spectrum when it comes to public health matters.
“I really want this department to bring people together and not be divisive so that we can actually do the things that we said we would do.”
The health department expects to receive about $4 million next year from the state, about four times what it got this year, and more the following year. To help plan for those new resources, the department will host three meetings over the next month. They’ll happen August 31 at 6 p.m. at La Casa De Amistad in South Bend, Sept. 14 at 6:30 p.m. at the New Carlisle Library, and Sept. 23 at 10 a.m. at the Mishawaka Holiday Inn on Douglas Road.
Purushotham says the department already has access to data that show it needs to improve health outcomes in the county.
“I’m really excited about it because it gives the health department an opportunity to really engage with people and have conversation and dialogue about A. what are we doing and then B. what can we do better?”
The problems won’t be easy to solve. For example, 74 of Indiana’s 92 counties have better infant mortality rates than St. Joseph County. And that’s in a state with the nation’s ninth-worst infant mortality rate.
“Big topics that we know we can do better on are obesity, hypertension, chronic diseases, what can we do with that? Cancer prevention, how can we provide more support there, especially for early surveillance? Maternal, fetal and infant health, what can we to improve that and make a healthy impact for our community? There are large buckets of issues that we know we can improve on but trying to get more specific about how we do that in a cost-accounted model is going to be something we’re excited to work on.”
The problems won’t be easy to solve. For example, 74 of Indiana’s 92 counties have better infant mortality rates than St. Joseph County. And that’s in a state with the nation’s ninth-worst infant mortality rate.
“That issue of maternal, fetal and infant health, that is a complex issue. It’s a socioeconomic issue. It’s an access to health care issue. And there are so many layers to it. There are conferences about it. There are books about it. It is just not a straightforward issue.”
In the coming weeks, health department staff will get out to community events and spread the word about the three public input sessions coming up. Purushotham says she’s eager to make connections with the community, and to get started on improving health outcomes for everyone.
