Andrea Parker is director of health for the Peoria City/County Health Department, where she provides oversight of approximately 140 employees and a $9 million annual operating budget.

She earned a Professional Registered Nurse diploma from Methodist School of Nursing, a Bachelor of Science degree in nursing from Bradley University, and a Master of Science degree from the University of Illinois at Chicago, School of Nursing. She held a number of managerial positions at Methodist Medical Center before joining the PCCHP last year.

Also an educator, Parker was an assistant professor of nursing at Bradley University for four years, teaching courses primarily focused on the health concerns of infants and children.

She and her husband have two children and reside in Peoria.

Tell about your background, schools attended, etc.

I was born in Joliet to John and Janet Arbuckle, Jr., and I have one sister. My parents are native Peorians; however, my father’s line of work took them to Joliet early in their marriage. We moved to Peoria in 1966.

I attended McKinley School during the times the minority marching demonstrations occurred. It seemed to happen a lot. Once, our school was dismissed early with instructions to run straight home because one of the demonstrations was in the school’s neighborhood.

Throughout my school days, I regularly played with my dolls and my Barbies. Occasionally, they were involved in an accident, and I would have to rescue them and provide first aid. The cotton squares from jewelry boxes and Elmers’s glue make a great cast. This was probably the beginning of me having the need to care for others.

I entered Manual High School in 1975. I was active in tennis, the yearly spring fashion and talent show Manual hosted, and the Black Student Government. By senior year, I had made the Sterling Merit Award (top 8 percent of the class), National Honor Society, French National Honor Society, and school representative for Downtown Rotary, which, at that time, was a male-dominated organization.

I met my husband, Bryan, during my junior year in high school. We have two fantastic children, Landon and Brittany.

After high school, I attended the University of Illinois at Urbana. I wanted to be a pediatrician. After completing two years, I took the scenic route, got married, had our first child, and went into nursing school. After I finished Methodist School of Nursing, I got my first professional job in my desired department, working as a pediatric nurse at Methodist. My husband laughed at me when I called to tell him I had accepted third shift, 11 p.m. to 7:30 a.m. My career as a health professional was off to a great start.

Who or what influenced your decision to become a nurse?

I think that I’ve always had the passion to care for others. It’s almost innate to me. Growing up, I watched family members preparing for work, not knowing at the time what their actual health care roles were. They were always very crisply dressed in whites. Their uniforms were always neatly fitting, shoes white with no dirty markings. They always looked so professional. So, I think there wasn’t one specific influence, but a multitude of life exposures and an internal drive.

Describe your job at the Health Department.

My position as administrator for the Peoria City/County Health Department is a daily challenge. I oversee Peoria and Marshall counties. There are days I receive so much information-via e-mail, white paper mailings, telephone calls, etc.-trying to keep abreast on what’s going on in health care locally and all around the world. Not only is my position involved with the expected public health issues, but the bioterrorism preparedness planning and training is extremely overwhelming at times. Fortunately, I have a knowledgeable and capable leadership team that works well together and understands our role in the community. The daily operations are seen at the level of coordinators and managers who report to a group director-level person. I spend a great amount of time reading public health policies and issues.

Much of your career has been spent in the community health field. What interested you in this unique area?

When I worked in a clinical hospital setting, I really enjoyed my work. Every day was a challenge to help another patient or, in many cases, the same patients. It was working on my bachelor’s degree that took me to other clinical health care settings outside of the hospital. I was caught off guard when I received word that my position was in jeopardy during a downsizing, and that I would have to either change shifts or leave the department. That was a difficult decision, but I left the department and worked as a home health nurse. And although it wasn’t pediatrics, I enjoyed the experiences. I was exposed to the other end of the health care spectrum: aging, death, and dying. I recognized my passion was to work outside the controlled hospital scene and help people in their own home, their worlds. I learned nursing wasn’t limited to the technical skills I felt proficient in at the hospital, but far more demanding skills of compassion and cultural patient care. And I felt I had plenty of energy to deal with those in need. I wanted to be an advocate for those in need. Although we’ve come so far, we still have so far to go in the arena of health care delivery.

How do you balance your duties at the health department with teaching at Bradley? Why is teaching important to you?

That’s easy; right now, I’m not currently teaching on a regular basis. I do feel a void there, but I’m not sure where I would fit teaching into my schedule and still be effective. I’ve done guest lecturing, and I’ve maintained adjunct faculty status for the University of Illinois College of Nursing here in Peoria. Why is teaching important to me? I think teaching is important because it allows me to impact the minds of the novice students and share my challenges and accomplishments. At the same time, it allows me to keep my self abreast and sharpen my skills of leadership.

What are the top community health issues in Peoria County?

From a global health perspective, there are many: Chronic disease prevention, identification, and treatment; mental health issues; cost of health care; jobs; housing issues; education; drugs; and violence all impact how we take care of our health. However, in our community assessment for the past few years, cancer, mental health, and tobacco (lung cancer) were identified as the top concerns for the Peoria area.

Other national and local health problems are sexually transmitted diseases, heart disease, obesity, and stroke. When health care providers are attempting to provide disease prevention from a wellness angle, it all depends on what’s going on in the life of the patients as to how they practice their health care. I believe all people want to be healthy, but all people don’t have the same opportunities to be healthy-for example, employment that doesn’t offer health care benefits or the health benefits people can’t afford even though they’re employed. There isn’t enough money locally or federally to meet the medically underinsured or uninsured. That isn’t specific to Peoria. Public health is gearing up to work with the community once again to determine the main health issues identified in this community that public health can participate in addressing.

What’s changed in the last five years? 10 years?

Much has changed in public health in the last five to 10 years. The advancement of technology has changed the manner in which data is handled. Much of the work performed in the local health departments is submitted to the state program governing agencies for funding and assessment purposes. Multiple times daily we receive public health information and concerns of what’s occurring across the country and around the world. And often, we respond immediately. Our educational opportunities are no longer limited to classroom training; employees now can learn via satellite downloads, teleconference, and online. We continue to battle for federal dollars that aren’t aimed at medical care improvements, but other non-health needs. We spend more time in preparedness-focused activities.

Explain the services provided by the Peoria City/County Health Department.

We have several programs; some are mandated by the Illinois Department of Public Health and some aren’t mandated, but if funding is available, the services are offered. Our core services address: food safety, water and waste water safety, communicable disease surveillence, and vaccinations. We operate under the core functions of assessment, assurance, and policy development.

What are the misconceptions regarding the Peoria City/County Health Department?

The biggest misperception about our agency is that we exist only to serve the poor. That’s a huge fallacy considering we inspect all food establishments, we monitor waste water sources that drain into the land, and we provide programs that address the needs of pregnant and parenting women regardless of income. We provide foreign travel vaccinations to everyone. There are just so few health care services that accept public aid that we’re perceived as a health source that solely serves the poor. On any given day, we have a variety of clients in the building accessing a multitude of services.

Explain the rating system for restaurant inspections conducted by the agency.

Our restaurant inspections are divided into categories based on risks. Risks are determined by the number of people an establishment serves, the types and quantity of food served, the number of hours open to serve food, and temporary versus long-term food establishments. Food establishment owners pay a yearly fee based on their determined risk category. We inspect and license food servers such as the downtown push carts, school programs, bars and grills, and the larger establishments in the city and county. We also inspect food establishments after fire, as disruption of water and electrical services to a building may potentially affect the food supplies.

The above criteria determine the minimum inspections an establishment could have. However, as a result of any unacceptable practices, the amount of time a sanitarian takes to re-inspect will vary. As well, there are some food handling practices that will result in a termination of food services. Closures are typically temporary; or an establishment will be told it can’t operate the food service side of their business until acceptable practices are met.

The only food groups we really don’t get involved with are activities that serve food to a "closed" group of people and not the general public-for example, church functions.

Explain the Foreign Travel Department services provided.

The Foreign Travel services offered at the PCCHD are thorough. The information provided remains current with monthly computer downloads through a software system called Travax. When clients come into the agency seeking Foreign Travel information, the system allows us to enter the name of their destination and retrieve recommendations for vaccinations, general information about the country, types of diseases inherent to that country, and any special health precautions. It also provides travelers with any possible risky health situations. If the traveler is planning an itinerary of foreign visits, the Travax system will also provide information regarding any special vaccination considerations and health concerns when traveling between foreign countries. The cost to the client varies depending on the type of vaccination necessary.

How important are facilities such as Heartland Community Health Clinic to our community?

Heartland Community Clinic has been successful for the many years it’s been operating, meeting the needs of those in the working class who have limited funds and no health insurance. Many times there’s a waiting list. It’s extremely difficult and expensive to provide medical and dental health care services to those unable to pay, as well as those covered by public aid assistance, because of the historically low reimbursement cost as well as the delay in accounts receivable. Our community workforce is compiled of a variety of employers, and if employees aren’t available for work due to health reasons, employers lose in productivity, etc. There’s circulating literature that highly correlates health disparities to the social and economic status of individuals. If Peoria wants to be a successful, healthy community, people need to understand their health is important and services are available and accessible to them. I applaud the efforts the PALM group, under the direction of Dave Koehler, are making to introduce to the community to health-related topics such as obesity and healthy heart functioning.

Do you see an increase in families and individuals using the services provided by the health department and other clinics such as HCHC?

The economy appears to be having a slow recovery. Health insurance costs have continued to escalate, and employers want to cover those heightened insurance costs. As long as people with unmet socio-economic needs exists, health care services to assist them will have to be accessible. Our local sexually transmitted diseases rate is higher than many of the surrounding counties for the age group of 15 to 24 years old. Our senior population is growing, which is a group of people that, for the most part, has decreased incomes and potential for health risks. As families relocate for jobs and technology allows for worldwide travel, diseases such as flu and monkey pox will continue to enter our country, impact the health of our citizens, and trigger public health surveillance and response.

Tell about the health care services you’ve established in the tri-county schools. What do the services involve? Are the widely used?

I truly enjoy working with the schools. Schools are where the majority of children spend the bulk of their time, and they’re also the place to create trusting relationships with parents and families. I’ve been involved in school health for more than 10 years, initially as a volunteer nurse with the health fairs. I’ve worked with the Tazewell County public schools in East Peoria and Pekin and the Peoria District 150 schools. I continue to be consulted in child health-related activities. The school health needs were specifically tailored to meet the needs of children within the particular school systems. School administrations realize the importance of helping children succeed in school by addressing their health issues, which affect attendance and ultimately learning and grades.

One of the Tazewell school districts basically operates with a traveling registered nurse and school-based clinical assistants. This particular school system allows for the school health staff to administer daily medications, which works well, practically eliminating medication errors to the children and giving the parents a sense of comfort and relief that medication has been properly administered to the child during a school day.

The Peoria Public Schools’ health program is actually in three pilots: school-based health services with a family/pediatric nurse practitioner on site all school days, school-based with nurse practitioner half day during school, and seven schools that have access to a traveling nurse practitioner and a school-based clinical assistant. The health staff works closely with the district health care staff. However, all the schools don’t have these programs, and mental health needs continue to grow amongst children and adolescents.

The West Nile virus has been reported the last couple of years. Are health departments alerted to watch and keep track of new viruses and diseases?

Throughout the summer months, mosquito testing, trapping, and surveillance activities are high priority for public health. We provide many educational opportunities to alert citizens on mosquito repellant procedures. We hire a professor of biology each summer to operate our vector program. This program addresses the concerns of standing water and abandoned tires, as well as providing mosquito trapping and bird testing. We have staff certified as Public Health Pesticide Applicators who sponsor certifications in the application of mosquito larvicide. In summer 2002, Illinois led the country in West Nile virus victims; this year, we, along with other states, didn’t experience the devastation, mainly due to the early and ongoing surveillance efforts.

How has the PCCHD changed since 9/11? With public safety, reporting, awareness issues, etc?

The 9/11 event woke up America to how vulnerable we are as a country. Few people value the common good and see individual needs and freedoms as more important than the overall health of our nation. The public health infrastructures have been upgraded tremendously since 9/11, after many years of being neglected. In the past few years, public health has faced a new era of challenges in bioterrrorism and disease control and prevention such as outbreaks of Anthrax, SARS, West Nile, and other emerging infectious diseases. Technological advances have changed the public health response to real time as it relates to global communication. Funding resources have diminished, resulting in decreased staffing, expertise, and changes in service delivery. There have been changes in data collection systems, surveillance, performance measurement, and outcome management of quality improvement. We’re focused daily on the impact disease- and bioterrorism-related events may have on this community. Public health continues to work with the other community agencies to protect the citizens we all serve.

What else would you like our readers to know about the PCCHD?

Public health values the health of all people, and on an ongoing basis, we assess, plan, implement, and evaluate our program services to better meet the health needs in this community. We’re gearing up for the beginning of the community health assessment in 2004, and we’ll need the assistance of the community to do this. We can’t do it alone. It’s a community effort to take care of the citizens in the community. TPW