Do People Still Care About Public Health?

It was a scene right out of a made-for-TV disaster film at the Creve Coeur Safety Fair held in mid-October on the campus of Barnes-Jewish West County Hospital. There were emergency services, helicopters buzzing overhead doing maneuvers, fire engines and fake rescues.

The real sense of urgency, however, was in the flu-shot lines just to the east of the accident re-enactors and general hoopla. There were a couple thousand people hurrying as fast as they could to stand in lines that wrapped around two large parking lots. Frantic drivers parked their cards anywhere they could and pushed children and elderly parents toward the line. Everyone wanted to get in place before the cops shut it down and turned people away. A four-hour event, the line was stopped a half hour after opening because the line already exceeded the supply of 2,000 flu vaccines.

Then we had time to wait. And wait. As the line finally crept forward and two hours slowly ticked by I couldn’t help but think that in case of a real emergency we’re in more trouble than we know. All around us there were stories of doctor’s offices that had no vaccine or pediatricians who had run out of the vaccine for infants. Rumors of cancelled flu shot clinics were verified. The next day Walgreens ran out of flu vaccine. And this was only for the seasonal flu vaccine, not the H1N1 vaccine.

So what happens if that tinge of panic becomes full scale, out-and-out panic? It doesn’t take much of an imagination to see all that anxiety transformed into something much worse.

I can’t speak for the state of public-health planning, but when a corporate citizen like BJC Healthcare distributes in excess of 30,000 free seasonal flu shots and they run out in the midst of a final mob scene, what does that say about the state of our public health? I say it means we’re failing.

While there were doubtless some freeloaders in the bunch, I’d guess many people were in the line because they were unemployed, uninsured, underinsured, very young, very old, or simply couldn’t afford the cost of immunizing their entire family. At $25 a shot, a family of six would have to invest $150 to protect themselves from just one of the serious flu threats this year. No word on how much the H1N1 vaccine will cost, but it if it’s the same, that’s $300 to inoculate a family in 2009.

The most effective public health measures are preventative. Wash your hands. Stay home if you’re sick. Don’t send sick kids to school. Get vaccinated against the evils we know. Yet how many of us who live in an interdependent way in urban or suburban environments take these precautions? We all know people who pride themselves on never taking a sick day or the fearful among us who refuse to get vaccinated. To quote Walt Kelly’s Pogo, “We have met the enemy and he is us.”

Urban life is intimately tied up with public health. We depend upon vaccinations, the county health departments that allocate them, and the generosity of corporate sponsors to fulfill the needs of those with substandard or no health insurance coverage. Our illogical and haphazard delivery of disease-prevention services undermines civic health.

So when I look at public investments in the community, I wonder why public health is never mentioned. We fund safety improvements to the MLK Bridge to the tune of $1.4 million to address 14 fatalities since 1998. And yet 84 people have already died in Missouri this fall (through Oct. 10) due to flu or complications of flu and 1,441 new cases of flu (seasonal and H1N1) were reported in Missouri during the week of Oct. 3-10.

I’m not saying the MLK Bridge project is frivolous, but perhaps the civic cost of not investing in disease prevention is more than short sighted, it’s a tragic loss of focus on what is most likely to protect the lives of ordinary Missourians.

While you mull on that, you might also consider that the majority of our local and regional flu pandemic planning is based on 2006 models for the avian flu. I don’t know about you, but I’d like to rethink public road investments and other “high priority” public-improvement projects and think more about public health and what will really make our communities safer and healthier.

Disclaimer: Yes, this writer belongs to the millions of the underinsured even though she pays significant amounts of money monthly to keep her healthcare coverage current. Individual health coverage often neglects simple preventative services like flu shots while maximizing out-of-pocket expenses. So, yes, I did need that free flu shot.

– Deborah Moulton

Your Saint Louis at The Pulitzer Foundation for the Arts

Often artists show the rest of us how undervalued items (objects, buildings, land) should be appreciated.  High-end loft districts often started as dirt cheap studios for artists.  Where there is art & artists there is transformation.  October 30th is the opening of the Urban Alchemy/Gordon Matta-Clark exhibition at the Pulitzer:

The exhibition programming will connect the artist’s social activism to present-day St. Louis. The Pulitzer, in collaboration with Washington University’s George Warren Brown School of Social Work, is organizing programs that build upon Matta-Clark’s desire to imbue abandoned objects, buildings, and parcels of land with new meaning.  The Pulitzer hopes to help carry Matta-Clark’s legacy into the 21st century and to inspire a new generation of social activism through creative acts.   An interactive web presence will reflect this community-driven programming at  mattaclark.pulitzerarts.org/transformation. Through art exhibitions, programs, collaborations, and exchanges with other institutions, the Pulitzer aims to foster a deeper understanding and appreciation of art and architecture and is a resource for artists, architects, scholars, students and the general public.

The Pulitzer is open and free to the public Wednesdays from 12pm-5pm and Saturdays from 10am-5pm.

The Your Saint Louis part of the exhibit may have the most interest to the readers here:

In this section, we want to hear what your community means to you. We’ll ask to hear your stories and stories from your neighbors. You’ll be able to submit a walking tour of your (or your favorite) neighborhood to encourage others to explore your section of the city, we’ll invite you to share your photographs, and much more. This web page will be where we feature your St. Louis and what it means to you.

This will be a great opportunity for each of us to contribute information so it continually evolves.  The exhibit opens October 30, 2009 and runs through June 6, 2010.

– Steve Patterson

Metro Moving Transit Forward Without Streetcars

Through its “Moving Transit Forward” initiative, Metro is holding public workshops across St. Louis City and County to get folks thinking about transit needs and system expansion.  Rather than just let attendees dream up their own rapid transit lines on maps, a breakout exercise does a good job of sharing the stark financial realities of MetroLink expansion. Participants are given just a hypothetical $700 every decade for capital projects, when the average MetroLink corridor project costs roughly $450. As a result, it becomes quickly apparent that another Prop-M only buys roughly one MetroLink corridor a decade, if that. For example, the combined Northside-Southside corridors, just within the City, cost $800. The exercise also suggests that participants consider other, cheaper alternatives, such as Bus Rapid Transit ($35) or Commuter Rail ($300).

What really concerns me with this exercise is two-fold: 1) Northside-Southside is presented as the only big idea for City system expansion, and 2) Modern Streetcars are missing from the suggested tool box of cheaper alternatives. When thinking of streetcars, I’m not talking more vintage trolleys akin to the Delmar Loop project (that’s criticism for a future post). No, I’m talking low-floor, high-capacity vehicles that travel on cheaper-to-build, embedded, street-running tracks. But back to the first point, this former planner of the Northside-Southside concept actually thinks such a “big idea” is terribly flawed, and should even be scrapped.

To understand how Northside-Southside even came to be is to tackle the very complex history of system planning and evolution of MetroLink in St. Louis. Such history would be its own series of posts. But suffice it to say, the St. Louis region is still working off a 1989 system analysis produced by East-West Gateway as the basis for all its corridors. I admire Metro using their new Moving Transit Forward initiative to scrap the prioritization of that document that hasn’t been officially updated since 1991 in a failed attempt to lure St. Charles County. But showing a map of big ideas spawned from those very corridors dreamed up now twenty years ago is perpetuating flawed thinking. I know this in part, because the Northside-Southside Study, I worked on two years ago, also perpetuated inherent flaws.

In my opinion, the key flaw of the Northside-Southside Study was the dual purpose of serving both City riders and County commuters. As a result, speed of lines to the County became essential, but of course, at an expense. Faster trains meant taking lanes and closing intersections on arterials and complex designs inside Interstate rights-of-way, all for a fast-ride to Downtown. And given such premise, modern streetcars were deemed too slow, despite their lower cost. But in the end, many County stakeholders would view the project as a lower expansion priority, especially given a roughly billion-dollar price-tag, which ironically resulted from attempts to attract their ridership.

A political reality of Metro is that the County holds the purse and the populace (albeit in voters, if not riders). One can imagine then that if you can only expand MetroLink by one corridor a decade, the City will be waiting in line for some time. Plus, as Northside-Southside showed, the City doesn’t have as attractive exclusive rights-of-way to build MetroLink-looking lines easily.

Rather than compete in a game stacked heavily against the City, I advocate changing the transit ideas discussed inside the urban core. Modern streetcar corridors, such as Grand Avenue, would offer the City projects paired well fiscally with a County MetroLink extension each decade.

And there is still time for City transit advocates to be heard. One opportunity is attending the workshop scheduled for South St. Louis City 5-7pm this Monday (10/26/09):

• St. Louis Public Library, Carpenter Branch
  3309 South Grand Boulevard (map)
  St. Louis, MO 63118

– Brian Horton

A Vintage Parking Garage

Downtown St. Louis has many parking garages, too many in fact.  Most are as bland as you’d expect a parking garage to be.

The curving exit ramp of the Macy’s garage at 6th & Pine (map link) is anything but bland.

One of the two Kiener Plaza garages are visible from the exit ramp of the Macy’s garage, above.

It is hard to sustain a vibrant downtown with so much real estate used for car storage.  We built garages to accommodate everyone coming downtown but in the process created a downtown less attractive to visitors.

I just hope nobody gets the idea to list one on the National Register of Historic Places.  Wait, the city likes to raze historic buildings so perhaps we should get all of them on the register.  That may be the only way to reduce their numbers.

– Steve Patterson

Limbaugh Dropped From Rams Bid

Last week Rush Limbaugh was dropped the group seeking to take over the St. Louis Rams.  Opposition was mounting locally, nationally and even within the NFL.  Here is the poll question, answers and the final tally:

Q: Rush Limbaugh & Dave Checketts have bid on the St. Louis Rams. Reaction?

• I don’t like Limbaugh and this would make it easier to stay away from the Rams: 77 (30%)
• I don’t care who owns the team as long as it remains in St. Louis: 63 (24%)
• I don’t like Limbaugh, used to support the Rams, but will stop if he becomes an owner: 39 (15%)
• I don’t like Limbaugh but I would continue supporting the Rams: 32 (12%)
• I like Limbaugh and the Rams, great match: 19 (7%)
• I don’t have an opinion on Limbaugh buying the Rams: 15 (6%)
• I like Limbaugh but not the Rams/football: 8 (3%)
• I like Limbaugh so I might start supporting the Rams: 6 (2%)

What we can take away from these results is most of the readers here are Rams fans, or at least want them to stay in St. Louis. 134 of the 259 votes (52%) showed a positive view toward the Rams/NFL.  Conversely, nearly as many are not really interested in the Rams/NFL.  More of those voting dislike Limbaugh than those that do like him.  With Limbaugh out of the picture the focus shifts back to the region’s willingness to pay up to keep the Edwards Jones Dome among the NFL’s best:

The Rams lease agreement with the St. Louis Convention & Visitors Commission (CVC) requires the Edward Jones Dome rank among the top eight stadiums in the 32-team NFL on the Dome’s 20th birthday in 2015. If first-tier status is not met, the Rams lease would switch to year-to-year terms a decade ahead of schedule and the team would have the option to leave St. Louis.  (Source: St. Louis Business Journal, 5/16/08, Edward Jones Dome challenged to measure up)

Renovations to the dome will likely cost more in the coming years than the dome cost to build.  Estimates are in the hundreds of millions.  The hotel room tax doesn’t collect enough to fund the renovations that will be needed.  2015 will be here soon. Can we assume that if Dave Checketts and his partners are successful in buying a controlling interest in the Rams that they wouldn’t move the team out of the region?  Maybe.  Expect to hear much more about this over the next 5-6 years.

The best part is we won’t be hearing from Rush Limbaugh as a team owner.

– Steve Patterson