November 5, 2009

Public health leader
Fred Rusczek ponders poverty, flu and community

Fred Rusczek, former director of public health in Manchester, is currently serving as executive director for Child Health Services in Manchester. It’s a temporary role, but one that means a lot to him. Rusczek was recently honored by the Mental Health Center of Greater Manchester with a community leadership award. He was the public health director for 20 years in the Queen City and worked for the department for 33 years.

Q: So what do you do at Child Health Services?
I came here to kind of fill a temporary need for the agency in March 2008. I will be transitioning out of Child Health Services sometime in the next six to eight months. I came in here to help out after I retired as city public health director. … I felt I had something to offer Child Health Services helping it to meet its desire to address the growing need for health care and all the related services to produce a healthy child. ...The poverty level in kids in Manchester is rivaling that of Boston, L.A. ... [A recent report from the Carsey Institute and the University of New Hampshire Manchester reported that 25 percent of Manchester’s children are living in poverty, compared to the state child poverty rate of 10 percent, one of the lowest in the nation.]

What are some areas the city needs to improve?
When you think about what will determine whether a child grows up healthy, there are a number of factors and a provision of health care is only one of them. So developing a child with social connections and success in school is as important … as is health care. For Child Health Services, the average income is $13,300, so many of our families, by the federal definition, would be categorized as homeless, including folks who double up with other families. If $13,300 is the average income, those folks are not living in a single-family home, so … that impacts the health of the child. ... Forty-five percent of our families speak a language other than English. That’s a challenge. Language is a barrier to health as well. There is nothing that foretells the future of the health of kids [more] than the growing childhood poverty rate, 25 percent are living in poverty. That very, very much speaks to the issues and challenges ahead for so many families.

Where are some areas where you’ve seen improvements?
Certainly we’ve had our successes. What is really wonderful, we’re a city of a size where there is a lot of connectedness, so people work together. It’s that old saying, “many hands make light work,” and you can get things done. That sort of community spirit is what is Manchester’s strength. It’s not always viewed as a community that works together. … It all comes down to what you set your sights on, addressing the growing rate of childhood poverty in a collective and collaborative way. We can change that. There are a number of community people and business leaders that have freely given of their time. The solution to childhood poverty is a strengthened economy and job opportunities. 

How did you get into this line of work?
I went to school at Colorado State University and I majored in environmental health. I had six professors who came out of the U.S. Centers for Disease Prevention. They were enthusiastic professors and I caught their enthusiasm. I knew what I wanted to do with my life at Colorado State University and then I had the good fortune to pick Manchester as the place to ply my trade. My time as public health director was the most rewarding thing I could have ever hoped to do with my life. …

What about flu season? That must present its challenges.
Absolutely. In addition to serving low-income kids, we have special medical programs for kids with unique medical needs, autism, kids with feeding and swallowing issues, complex medical needs. The point is there are many giving seasonal flu shots to high-risk children as a priority, now overlaying with the H1N1 flu vaccinations in the middle of a growing concern about severity, particularly for the younger population. Particularly with additional medical challenges, it’s a priority for us. We have limited resources. ...  In spite of that, we’re trying to grow and serve more kids so when additional challenges come along, such as giving two flu shots, we do all that we can to make sure kids we serve get an opportunity to grow up healthy.

Was the [Carsey Institute] report surprising to you?
It didn’t surprise me because I have been looking at data my entire life. I had been looking at some right along. If you break it down even more than that, the 2008 child poverty estimates, it’s phenomenally high. It’s three times what we see in New Hampshire, three times what we see in Nashua. That’s significant. These are for all children, but when you get to families with children under 5, the numbers grow even higher, a little over 30 percent. So the future generation coming up, the younger kids, even a greater percentage are living in poverty. Therefore, there’s a greater percentage at risk. At Child Health Services, we recognized the community need. We now serve about 1,500 children in our pediatric clinic and another 600 to 800 in our [teenage clinic], then about 2,000 in our special medical services. — Jeff Mucciarone