Directing care
By Phyllis Moore
Published in News on September 2, 2015 1:46 PM
Wayne County Health Director said he is often asked what it is like to have that job.
"Imagine standing in a room full of land mines, juggling plates and dodging water balloons while trying to get to the other side blind-folded," Davin Madden said. "If you can imagine that, that's what it's like to be a health director every day because you're trying to make people happy, you're trying to get good services, keep staff morale up, but at the same time you're trying to juggle through all the challenges -- I don't want to say political, but it's people trying to impact your funding. You're trying to do the best job you can but everybody wants to address your money. At the same time, you don't want to make anybody mad."
The public health business contains a lot of moving parts, he says.
Every day is different, and there are usually no "quick-fix" scenarios in staying true to the mission -- to continually monitor and improve the health of the citizens of Wayne County in the best way possible.
In spite of the challenges, he thrives on the unknown elements and manages to enjoy his job.
"I have never been bored working in public health. I have never had a day where it's like the same-old-same-old," he said. "If you're going to do something, do something that matters to you. That's an individual discovery.
"But especially do something that you enjoy and even more so that you don't mind doing every day, or that when you get up, you're happy doing it. I get up out of bed in the morning, I'm happy to come to work."
The realization has been a long time coming, though.
Growing up in Kenansville in Duplin County, his only exposure to public health was hearing it mentioned once in a food and nutrition course he took in high school.
He held several jobs after graduating from UNC-Wilmington, including teaching physical science at a middle school and working in environmental health in Duplin and then Greene counties. After three years as health director in Pamlico County, he was hired three years ago to work in Wayne County.
The most prevalent health issues he sees in Wayne County are melanoma, diabetes and heart disease.
"We have seen some rise across the board in melanoma, skin cancer," he said. "I think that's really indicative that people are outside. Things we take for granted, wear a hat, sunblock."
In addition to making sure that people have a medical home, Madden said many of the health issues they face can be boiled down to one thing -- lifestyle.
"Most of the time people have shorter spans or losing life are related to preventable causes," he said. "This current generation of children, it's predicted that they may not live as long as their parents, based on quality of life.
"We're talking about the fact that they're not going to live as healthy. That should resonate with anybody in a community."
Some simply do not seek medical care, ignoring symptoms or procrastinating until there is a problem. Investing in one's health and well-being should be more of a priority, the health director said.
"You do have to care about yourself, and you have to care about the people that you influence because only in that regard do we send the right message forward," he said. "I think we have got out of the habit of people prioritizing their health.
"We'll make sure that we put in at work that we want to be off at Thanksgiving, but we fail to make an appointment to check our health."
The "health culture" has shifted over the years, he said. Instead of maintaining good health, most people these days are responding to things that crop up which, in many cases, could have been prevented.
Doctors, in turn, become reactive in their treatment rather than proactive. In that scenario, Madden said, the patient is taught how to manage poor health rather than being restored to improved health.
"You want to shift the social awareness where people are going to live in good health and not merely exist in poor health," he said. "Reinforce how important it is -- a lot of the issues that are still killing us today, the leading causes of death, if not all of them, are reversible."
Diabetes, for example, can be managed or even warded off, by changing diet, exercising and losing weight, he said. The same holds true for heart disease and high cholesterol.
"That's the main thing that's kind of puzzling," he said. " Going back a few decades, in general, a lot of medications were really there to resolve symptoms until you were well. Once you get well the medication was no longer necessary.
"Now, though, it seems like the system is, when you're ill, take it until you die."
There will be things that people are genetically disposed to acquire, he said, and points out his criticism is not directed at the medical community.
Rather, he suggests that people have more control over their health than they may realize, or put into practice.
"From a social cultural standpoint, doctors are doing what they're sworn to do, manage a person's pain," he said. "But wellness ultimately resides within the individual."