January 25, 2013
Dear Fire & Rescue and Water Bureau Employees,
I just wanted to write to say how honored I am to be - even if only for a few weeks - the Commissioner in Charge of the Fire & Rescue and Water Bureaus. I was going to send a separate email to employees of each Bureau, but then it occurred to me that, in a way, you're all in the same business. You're all in the business of saving lives. For that I thank you, and am honored to be associated with you. Also - as you'll see at the end of this email - I have a small suggestion as to something each of us might do that will save some more lives.
I'm sure each of you knows the life-saving story of your own Bureau, but you might want to check out the statistics for your colleagues in the other Bureau. Going alphabetically, I'll start with Fire. According to FEMA, fire deaths in the United States have declined by more than two-thirds just since 1979, from 34 per million to 11 per million. In Oregon, we do even better than that: 7.8 per million. Stronger building codes (and enforcement of those codes), smoke alarms, and the tireless efforts of our firefighters have dramatically reduced the threat of fire to Americans, Oregonians and Portlanders.
And, of course, especially in recent years, firefighters have taken on an enormous life-saving load of non-fire medical calls - 40,000 in Portland last year. Heart attacks, injuries, diabetics in crisis. We spend 17 percent of gross national product on the health care industry in this country; you'd think that would reduce the number of health emergencies. But it hasn't. And the consequence of the failure of that massive spending on health care to reduce the number of health emergencies is to give firefighters an ever-rising medical workload ... which you have shouldered calmly, professionally, and effectively. Thank you.
Now to the Water Bureau. I think most Portlanders know that firefighters are in the life-saving business; I'm not sure they view the Water Bureau the same way. But the Water Bureau IS in the life-saving business. Here's what the Water Quality and Health Council says:
At the start of the twentieth century, high mortality rates and substandard living conditions were commonplace in urban America. Mortality rates in major cities were substantially higher than in rural areas, a phenomenon known as the "urban penalty." Yet by 1940, mortality rates had declined by a full 40 percent, mostly due to a reduction in infectious diseases. In addition, the urban penalty had largely disappeared, with life expectancy rising from 47 to 63 years.
What fostered this rapid and revolutionary change, the most dramatic reduction in mortality ever recorded in the United States? There has been much debate on this question, but relatively little empirical data provide a verifiable answer. However, a new study by two Harvard University researchers, David Cutler of the Department of Economics and Grant Miller of the Health Policy Program, finds the most compelling root cause for the drop in U.S. mortality rates in the twentieth century was the adoption of treatment technologies for public drinking water supplies.
In their recent article, "The Role of Public Health Improvements in Health Advances: The Twentieth Century United States," Cutler and Miller conclude that clean water technologies, filtration and chlorination, were responsible for nearly half of the total mortality reduction in major cities between 1900 and 1936, with even greater impact on infant and child mortality rates during that same time period. Significantly, these technologies led to the near-eradication of typhoid fever, the waterborne disease that was one of the major scourges of that era.
So, according to these researchers, the existence of clean, safe, reliable urban water systems such as Portland's may have increased life expectancy by as much as 16 years. Thank you, Water Bureau employees!
Now, if you've read this far, you might remember that I said at the start of this email that I would have a suggestion as to how to save some more lives. It's this. Please get your blood pressure checked, and urge your loved ones to get their blood pressure checked. And if it's high, get it under control. It could save your life or a loved one's life. Less dramatically, but still importantly, it could reduce the cost of health care to the City and make more money available to the City to preserve high-quality services.
According to a New York Times editorial a few months ago, 30 million Americans have uncontrolled high blood pressure even though they have health insurance. That's one in ten Americans - so it probably includes some of you. That puts them at risk for heart attacks, strokes and kidney failure. And it's unnecessary. Many of us can control high blood pressure through diet and exercise - but even for those of us who can't, blood pressure medication is effective and (unlike, say, triple bypass surgery) really cheap. http://www.nytimes.com/2012/09/09/opinion/sunday/simple-treatments-ignored.html?_r=0
I am told that each fire station has blood pressure-checking equipment, and that the Water Bureau has blood pressure monitors on the 6th floor of the Portland Building and Interstate, and will shortly acquire equipment at Headworks, Lusted and Sandy River Station.
I offer this advice, by the way, as an overweight middle-aged guy who, over the past decade, has had moderately high blood pressure. Every time I went to the doctor, he told me it was a bit high. I kept on saying, OK, I'll eat better and exercise. But I didn't. Finally, I started taking the pills. Now, my blood pressure's under control. Recently, since my fiancee' got me a pedometer and we got a dog, I actually have been exercising more: walking to meet my target number of steps and walking because, well, the dog has to be walked. So perhaps my blood pressure would be OK even without the pills. I might try to figure that out this year. But I won't go back to ignoring it. It's too big a risk to take - and I don't want to unnecessarily add to those sky-high medical costs that burden the whole country generally and the City budget specifically.
Okay, I've gone on long enough. But again ... thank you, thank you, thank you for the vital, life-saving work you do.
My very best regards,
Commissioner Steve Novick
City of Portland, Oregon