Serving the Community: A Closer Look at Public Health

What does public health really look like in Boone County—and how does it impact you?

In this episode of Healthy Talk, we sit down with Lydia Billings, Director of Public Health at Boone County Hospital, to take a closer look at the work happening behind the scenes to keep our community healthy.

From prevention and community education to partnerships with local schools, organizations, and emergency services, Lydia shares how public health supports individuals and families at every stage of life. We also talk about how healthcare is evolving, what that means for Boone County, and how a stronger focus on public health helps serve the entire community.

Whether you’ve interacted with public health services before or not, this conversation offers a better understanding of the role it plays—and how it continues to grow to meet the needs of Boone County.

Stay informed, stay healthy, and keep the conversation going with Healthy Talk.
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Transcript

Welcome & Introduction

SPEAKER_01 0:04

Hi everyone and welcome to Healthy Talk, Empowering Your Wellness One Conversation at a Time. Today we're talking about something that touches every single person in Boone County, public health. You may have seen the recent announcement from Boone County Hospital about the upcoming transition of home care services and adult day services later this year. Whenever healthcare changes, it naturally raises questions in the community, and that's completely understandable. But today we want to spend some time talking about the bigger picture, what public health means, the work that's happening behind the scenes, and how strengthening those efforts supports the health of our entire county moving forward. Joining me today is Lydia Billings, Director of Public Health here at Boone County Hospital. Lydia, thanks for being here today. Yes, thank you. For listeners who might not know you yet, could you tell us a little bit about your role and how you got here?

What is Public Health?

SPEAKER_00 0:55

Yeah, so I have been with the department for coming up on five years, the director for one year and assistant director for the previous four. And as far as my role and responsibilities go, most people probably had interactions with me related to either home care or community services. But our public health duties vary greatly. So we do a little bit of everything from disease investigations to emergency preparedness to health education.

SPEAKER_01 1:24

It sounds like there's a lot more variety to the work than people might expect. When people hear the term public health, what does it really encompass in a community like Boone County?

Transition & Strategy

SPEAKER_00 1:36

So when I think of public health in Boone County, I'm looking at wanting to make an impact to the greatest number of people. So that might look a little different in each community depending on what the community needs are. So for example, although they may appear close on a map, Madrid may have a lot different community health needs than Ogden or Boone. So my goal as a public health director is to use what resources we have in the most effective way while also constantly evaluating what gaps still exist and how we can assist in those.

SPEAKER_01 2:08

So recently, Boone County Hospital announced the transition involving home care and adult day services. As health care delivery continues to evolve, how does strengthening public health fit into that broader strategy for serving our community?

SPEAKER_00 2:25

Yeah, I think that's a great question and something that probably many of our community members are wondering about. So historically, our public health department has done more or less kind of behind the scenes work versus that community outreach where you see us out and about. So although the closure of these services is obviously a huge transition for our community, I think one takeaway is that it allows for our focus to be entirely on public health and the community as a whole. So moving forward, we will be looking at resources and community needs of all ages and how we can build and collaborate with organizations that are already in our community.

SPEAKER_01 3:03

That's great. I think collaboration is key in anything you do. You did mention earlier that public health looks at the community as a whole. How does that differ from hospital-based care? And why are both so important in rural health care?

SPEAKER_00 3:21

Public health focuses more on preventing problems across the whole community while hospital-based care is looking more at treating individuals when maybe they're sick or injured. So, in essence, we are trying to find ways to prevent chronic injury and disease so that individuals are safer and healthier and can, in the long run, hopefully avoid some of those hospitalizations. In a rural area, you really need both the community health and that one-on-one care to work together. So, a good example of that would be if you were thinking about a stretch of some icy, not so great weather. So, say that leads to a spike in falls among older adults. Public health could notice that trend and then partner with somebody like the county to improve sidewalk sanding and maybe do a fall prevention program for seniors. So at that same time, the hospital is treating those people who did fall and maybe they broke a bone or had a minor injury. Public health tries to reduce how many people get hurt. And the hospital helps those who do get hurt recover. So in a rural community, the combination of prevention and treatment is kind of what keeps the whole system strong.

Behind the Scenes

SPEAKER_01 4:30

Gotcha. It sounds like a lot of work happens behind the scenes in public health. What are some examples of that kind of work that people might not realize is happening?

Prevention & Intervention

SPEAKER_00 4:41

Some of the most meaningful work that we do in public health probably is the stuff that people don't see. A good example of that would be the disease investigations and follow-ups that we do. There are certain illnesses that are considered reportable by state law. And we as public health work with providers and HHS to investigate those. So to break it down, an example could be that we start noticing unusual patterns in our county data, like an uptick in something called Alpha Gaul syndrome. So most people that would have that experience kind of the confusing part that they're reacting to red meat and not knowing why. But behind the scenes, our team is looking at the bigger picture. So we're talking to the individual that has this disease or illness, but we're also working with local providers, looking for clusters. And in this situation, we could even partner with the DNR when we see that those numbers are creeping up. So, for example, if we did notice that and we had a spike in that data, we can work with the DNR to push out alerts about things like tick activity, trail conditions. A lot of people on the outside are not seeing that work happen, but oftentimes the data that they are seeing comes from public health behind the scenes. An additional way that we could help if we saw an uptick in this is adding new signage to a trail or walking path, adjust mowing schedules, or just increase public education in that area to help people stay safe and avoid whatever the illness is.

SPEAKER_01 6:14

Why is prevention and early intervention so important for long-term community health?

SPEAKER_00 6:22

I think of them as honestly like the backbone of long-term community health. It's a lot easier and honestly a lot less expensive to stop a problem earlier than to deal with the fallout later. So when we are seeing these things and trying to step in upstream, we can keep small issues from becoming really big ones. So that might mean things like catching a trend in our county data before it turns into a bigger problem or helping people get connected to resources before their health declines.

SPEAKER_01 6:53

So as healthcare models shift, what opportunities does that create for public health here in Boone County specifically?

SPEAKER_00 7:01

I think it gives us a pretty unique opportunity to find solutions the community is asking for and that they actually need. So one thing I wanted to touch on with this was that every three years, the hospital sends out something that we call the China, but that stands for the community health needs assessment. And it's a survey that the community members and stakeholders have an opportunity to take and then provide feedback on services or gaps that are currently happening. So my goal in public health is really to focus on the top priorities that our community has brought up that are important to them. From 2025, these areas were behavioral health, cancer, and diabetes. And unsurprisingly, these align pretty closely with what was shown on the state health improvement plan. So we want to use available funding sources on those services that are already available, and then also look at new services or resources that we could possibly create programming for.

SPEAKER_01 8:00

I love that, letting the community kind of guide what they feel is important in healthcare services. Yeah. Do you have any programs or initiatives that you're especially excited about expanding in the coming years?

Community Partnerships

SPEAKER_00 8:12

We have some really great opportunities. And I want to just have as much community involvement as possible. One thing that we're working on right now that I'm really excited about is we're working with a program called Steps of Hope. And what they do is offer essentially Narcan distribution boxes for different communities so that anyone, essentially anywhere in the community, can come and grab Narcan from this distribution box. And we actually got three boxes, and so we are going to be placing one of those in Boone, one in Madrid, and one in Ogden. And I think there is potential to possibly expand those to other areas as we kind of see how things transpire. But I think that's really going to be a good resource for the community. And like I said, anyone can access it. So hopefully it takes away some of that stigma of maybe somebody who has a history of drug abuse or use to go into a store and ask to get Narcan. They can just go to these boxes and grab it, or maybe their family member or a friend can do that. And then there's actually a link to training right there on the box that they can scan. It's a QR code. So yeah, I'm really excited about rolling that out and kind of seeing the data that we get back from that. In general, our whole goal is to support our community to be the safest and healthiest that it can be. So I'm just really excited to get to be a part of the community in new ways, get out there, meet new people, build new relationships, and collaborate with the organizations that are already offering a lot of these resources.

SPEAKER_01 9:52

That goes perfectly in my next question, which is that public health depends on those partnerships. So how does your department collaborate with other organizations in the community?

SPEAKER_00 10:02

There's several ways, and I'm sure I'm gonna miss some of these, but the most common would be we go to schools and daycare centers annually to complete their immunization audits. So that's one way. Working with our local EMAs, ambulance, fire and rescue to touch on emergency preparedness response and make sure that we work together on those scenarios so we're the best prepared we can be for an emergency or natural disaster. And then another example would be working with Boone High School students to have a tour here at the hospital, and different departments are working to set up STEM events for them. So it's a wide variety.

SPEAKER_01 10:40

I love how many connections public health has throughout the community. And education also seems like a big part of what you do. So, how do you approach that in a way that connects with people?

Looking Ahead

SPEAKER_00 10:51

Education is honestly one of the most powerful tools that we have in public health because it helps people make informed decisions ideally before a problem becomes serious. So most of what we do isn't about telling people what to do, but it's more about giving them clear practical information so they can protect their own health and the health of their families. I like to tell people that I don't see my job as judging someone's situation or offering like a right or wrong solution. But I really want to understand where people are coming from individually so we can hopefully come up with a potential solution that's right for them. In a rural community, especially reaching people where they're at really matters. And that might mean sharing updates through local partners, meeting at community events, tailoring information to what we're actually seeing in our own county versus state level data. And one thing about rural communities is that the data can show one thing for our state, but those issues might not be the top problems in a certain area that has to drive maybe 30 minutes to the nearest hospital. So building that trust within our community so that people are comfortable and confident to share their stories with us is really important to me. Some health problems that we have currently do align with the entire state of Iowa. But I want our community to know that my first priority is us, the ones who are living and working in Boone County. Absolutely.

SPEAKER_01 12:19

Let's look ahead three to five years. What do you hope will be stronger in Boone County because of the focus on public health?

SPEAKER_00 12:28

I hope our department primarily continues to be a bridge between the hospital and the community because when people understand how all of our pieces fit together, it seems like everyone benefits more from that. So my focus moving forward is making sure that we're using the resources we have in the smartest way possible so we can meet the real community needs and make the broadest impact. The people I work with, both in the hospital and out in the community, truly genuinely care about helping others and trying to make a difference. So it's really important for me that people can trust myself and my staff and know that their health and well-being are really at the center of every decision we make.

The Bigger Picture

SPEAKER_01 13:10

That makes a huge difference. So change sometimes can feel uncomfortable, especially when it involves health care. What would you say to someone who maybe feels uncertain when they hear about all the changes happening?

SPEAKER_00 13:26

I think the most important point is that it's really valid that change does feel uncomfortable. Um, I even experienced that in my own life. It's always a little scary because we're never 100% certain of how something might play out. But specific to this transition, I just want people to know that change doesn't mean that you're losing support. But our system is adjusting so it can keep serving the community in the best way that we possibly can. So public health is still here. Our focus is still making sure that people have clear information, supportive resources, and obviously a place to turn when you have questions. So I think it's just important that we stay open to change and avoid kind of that siloed thinking that I think happens sometimes when programs run for as long as they have. My personal opinion is that healthcare works best when we're willing to look at the bigger picture, share information with each other, and kind of try to adapt instead of holding really tight to this is the way things have always been. When we stay flexible, I think we can respond better to new challenges and use our resources wisely. And our whole goal is to build stronger partnerships within the community. Absolutely. I could not agree more.

SPEAKER_01 14:42

Before we wrap up, what motivates you personally in this role?

Connecting with Public Health

SPEAKER_00 14:47

I've always been really passionate about helping people. And one thing that I've learned is that healthcare is not one size fits all. So what I'm really looking forward to in public health is hearing the stories and experiences of the people in our community because not only does it help me understand where our support can make a big difference, but I also think it's important to know where people are coming from when we're trying to offer support. And I try to stay really open-minded in my views on public health. I really value being surrounded by people who don't just automatically agree with whatever I might think. And I found that having different perspectives makes our work a lot stronger and helps us serve the community in a more meaningful way. So I think it's really interesting in public health that we can take an opportunity to kind of have a creative approach for how we might meet the community needs. As I mentioned earlier, just because we all live in Iowa here, it doesn't mean that our health needs are the same as even the next town over. So I think public health is really neat in the way that you can kind of get creative of how you meet the needs in one community versus another community. So kind of thinking outside the box. And I am a natural problem solver, so I really like collaborating with other organizations on issues and kind of trying to think of different solutions to the community problems.

SPEAKER_01 16:13

If people want to connect with public health services or learn more about your department, what's the best way for them to get involved?

Closing Thoughts

SPEAKER_00 16:21

I think the first thing is probably just taking the time to try to understand what our public health purpose is and asking a lot of questions. I have always been a firm believer that no question is a bad question. So we get questions of all sorts pretty much all day long, and that's totally okay. If we don't offer a resource for something, it's likely that we can point the person in the direction to someone who either offers it or if there's nothing like that in our community, we take note of that and then we bring that to the meetings and coalitions that we're part of to try to combat some of those gaps. The other thing too is when we send out things like surveys or ask for community feedback, we are truly doing that because we value the community's feedback and we don't want to offer resources that are not impacting people because that's not the purpose of public health. So when things are going out and around and we're asking to, you know, show up to a community event or offer an opinion on something, please do and please be honest with us so we can meet the needs as best we can. And letting us know what you need as a community member health-wise is what helps us determine programming and potential grant opportunities down the road. We're available Monday through Friday, 8 to 4:30. And if you are not already following the Boone County Hospital Facebook page, our public health events and updates should be shared through that. And yeah, plan to attend the community events and stop by and introduce yourself.

SPEAKER_01 17:53

Awesome. Lydia, thanks so much for taking time to share about the work that's happening right now in public health and the vision that you have for Boone County moving forward. Thank you to everyone who listened today. If you want to find more information about public health, you can visit our website at www.boonhospital.com. Until next time, stay informed, stay healthy, and keep the conversation going with Healthy Talk.