Connecticut’s public health districts play a serious and important role in helping keep communities healthy and safe. Individual districts work to ensure safe food handling in restaurants, educate about the risks of lead poisoning, operate flu vaccine clinics, approve plans for new septic systems, ensure and coordinate emergency medical preparedness and help prevent chronic and communicable diseases, to name just a few of their programs and duties.

Unfortunately, however, the degree to which the public’s health is protected in the state depends too heavily on geography. There are 74 public health entities across tiny Connecticut, according to the state Department of Public Health. These include multi-town public health districts such as Ledge Light and Uncas here in southeastern Connecticut. In addition, some communities operate independent full-time health departments, while other municipalities such as Stonington and North Stonington have part-time municipal health departments. The two sovereign Native American nations operate independent health departments.

All this results in a fractured system full of inconsistencies, disparities and inefficiencies for the public. A bill submitted to the state legislature seeks to end these disparities and create a regional public health system aimed at standardizing operations and services. The proposal, scheduled for a March 7 legislative public hearing, is strenuously opposed by many municipal and regional health district officials.

While we tend to agree the current proposal may not be the best solution, we also support the state public health department’s intentions. We don’t believe a resident of one community is more deserving of comprehensive public health and safety than is a resident of any other community.

In its current form, the proposed legislation calls for significantly fewer health districts covering all the state’s residents. If the bill is adopted, effective in 2020, the districts would be organized around the current Council of Governments districts and funded in part on a per capita rate by the member municipalities.

State Public Health Department officials contend this will end a great disparity of costs for public health. Currently, for example, the cost of membership in Ledge Light Health District calculates to $7.29 per capita, compared to $6.48 per capita in the Uncas Health District and $11.65 per capita in the Connecticut River Area Health District.

The bill further calls for community health needs assessments to be conducted once the new districts are formed. This would help ensure the services being provided are the ones that are needed. In addition, a reconfiguration and reduction in the number of districts statewide could seek to reverse an administratively top-heavy system. There are currently more than 70 health directors statewide and just over 50 public health nurses.

Stephen Mansfield, director of health for Ledge Light, says the bill as written would not accomplish what it sets out to do, however. “The new large districts will still have a wide range of per capita contributions from their member municipalities, programs and services will still be determined by each new district, and the state contribution is at the mercy of the appropriations committee,” he said, pointing out that health district funding from the state was cut by 11 percent in the current year’s budget and the governor’s proposed budget includes another 20 percent reduction.

We can’t agree with some local officials’ contentions that the current system is not broken and doesn’t need fixing. We strenuously advocate for all towns to be members of a regional health district rather than providing these services independently, for example, because that would more consistently and effectively ensure the public’s health and safety. But a new set of larger health districts that continues to allow disparities is not the answer and, at a time when municipal budgets are stretched to the maximum and being further threatened by more state cutbacks, we can’t support new mandates that add to municipal expenses.

If legislators, state, local and regional public health officials work together with the common mission of ensuring efficient and effective public health equity across the state, however, a solution should be within reach. The proposed legislation could be a jumping off point to working toward that goal.