2 min read
Posted on 01.15.09
  • 2 min read
  • Posted on 01.15.09


Considered by rate (that is, the number of reported cases per capita), St. Louis had the highest rates in the country last year for a couple of sexually transmitted diseases.

Reports about this drew a predictable public response from acting city Health Director Pam Walker that ranking these diseases by rate was misleading and sensational. (This is the same response made to a lot of the national lists.) In this case, small St. Louis reported 4,398 cases of chlamydia, ranking by rate higher than giant Chicago/Cook County which reported far more (30,881) cases. Ms Walker notes that, given the differences in populations counted, St. Louis would have to reduce by more than half the number of cases reported to reach Chicago’s lower rate.

But, eschewing the response of a cautious bureaucrat, Ms. Walker went on to say she and her department planned to do just that.

There is evidence in the data that she can do it. In just one year of newly re-focused effort, Ms. Walker’s department and its community partners have already reduced the number of cases of chlamydia and gonorrhea by ten percent.

They have accomplished this, she said, by treating STDs as a community health problem, not just as a City Health Department problem to be addressed from its headquarters in Grand Center.. That has meant going out and testing and treating thousands of people — more than seven thousand in a year. It has meant opening and staffing a one-stop drop-in center for teenagers, a seriously at-risk group in the community. And it has meant going into schools (including every city high school and middle), community centers, and homes to discuss STD prevention with students, young people, and parents.

The STD rate rankings are the sorts of evergreen stories that are reported by the news media each year. Counting cases and comparing rates, we will know in a year if the positive trends of Ms. Walker’s efforts carry over.