It has been almost two years since Delaware County commissioned Johns Hopkins University to conduct a survey of the gaps in public-health coverage.
And it has been seven months since George Avetian, a family-practice physician in Upper Darby, was appointed senior medical adviser to help coordinate public-health efforts in the county and fulfill the first of the study's recommendations.
The county does not have a county-based public health department. The county's Department of Intercommunity Health acts as a referral center on public-health issues.
In a recent interview, Avetian said much has been accomplished since he accepted the position.
"Our [yearly] goals are pretty much met at this point," said Avetian, who lives in Radnor Township.
The county, for instance, has created a Health Advisory Board, he said.
Avetian has met with both public and private health-related groups. He is in discussions with a local corporation to see if it will provide access to a health van to be used for educational purposes in underserved communities and provide screenings for diabetes and cholesterol, and flu immunizations.
A Medical Reserve Corps, a group of medical volunteers trained to respond to public emergencies, has been formed, he said. The county has participated in the Strategic National Stockpile plan and conducted drills to ensure the smooth delivery of a large quantity of medical supplies needed to protect the public in case of an emergency.
There have been three flu-shot clinics that ran in conjunction with food drives; the county and its district attorney's office participated in the National Prescription Drug Take Back Day; and a news conference was held to alert the public to the dangers of synthetic marijuana, he said.
With 49 municipalities in the county doing things 49 different ways, carrying out a coordinated mission of public health is a daunting task, Avetian said.
"That is a challenge down the line," he said.
Avetian has created a Facebook page. Twitter, he said, "is next." While that may not seem like a huge accomplishment, in a county that has been slow to embrace social media, it is significant.
But the Facebook page is his and not the county's. It was created Nov. 28 to disseminate announcements and health tips, and has only a handful of followers.
Only two of five yearly meetings of the Health Advisory Board are open to the public. On Nov. 30, the last scheduled meeting, there were only "a few" attendees, he said.
In September, a Women's Health Fair was held at the county Government Center in Media. Of the "couple hundred" attendees, Avetian said half were county employees. A survey of who else attended or where they came from was not conducted.
Rosemarie O'Malley, a member of the private nonprofit Working Group for a Delaware County Health Department, said more research was needed to make sure the programs reached those who could benefit the most.
"A big part of what public health does is to monitor effectiveness," she said.