October 26, 2016

“With Public Health It’s a Marathon”: Jeff Grosser, Princeton Health Department


KEEPING PRINCETON HEALTHY: Jeff Grosser, Princeton Health Officer, is always on the go in his “constantly evolving job” of overseeing the Municipal Health Department.

Jeff Grosser, 32-year-old New Jersey native, came to head the Princeton Health Department in April 2014. He lives in Burlington County with his wife and three daughters, ages five, three and eight months. In his scarce free time, he loves going to the beach and surfing on Long Beach Island (LBI, where his parents live), playing soccer and coaching his daughters. He almost chose a career in professional soccer over public health.

As Jeff looks to the future, he looks forward to “making Princeton the healthiest town in New Jersey. When I wake up that’s what I’m thinking about.” Here, in his own words, Jeff talks about how he became a health officer and how he does his job “to preserve, promote and improve the health and well-being of the people, wildlife and environment of Princeton.”

Early Influences

I grew up in Hopewell for seven years, with two older siblings, then my family moved to Fairfax, Virginia for seven years, then back to Medford, New Jersey when I was 14.

My initial interest in medicine and the environment started in LBI because in going to the beach, being around the ocean, you’re outdoors and you get a sense of how the environment interacts with humans.

My dad was a mechanical engineer at Mobil labs, and that’s where I got some of my environmental insights. I noticed how careful he was in handling various oils and gases as we were growing up. He would always educate us on the harmful effects of gas and being careful with things like that.

While playing soccer in high school, I got the idea that I wanted to be healthy, that the way I treated my body as an adolescent would probably carry over into adulthood. Playing soccer was important to me — not only from the love that I had for the game, but also it was keeping me healthy. I was a High School All-American at Shawnee High School and the New Jersey State Player of the Year.

I was recruited by several schools but decided to go to Johns Hopkins because of its reputation in medicine and public health. I wanted to be a pediatrician, because when I was growing up I always worried about going to the pediatrician and I wanted to be the kind of pediatrician that kids wouldn’t be worried to go see.

Hopkins has such a strong program in public health and I learned to love the school’s motto: “Saving lives, millions at a time.” It’s about saving populations, and when I learned about the environmental health aspect, I realized this is what I want to study. I was fascinated by how much a particular environment or community could affect a person.

A Crossroad

When I finished up at Hopkins, playing soccer and earning a public health degree, I came to a crossroad. I always wanted to be a professional athlete. I played semiprofessional soccer for a team in Baltimore as I was finishing up senior year, and I also worked as assistant coach at Hopkins. Also, Hopkins has a fantastic program where you go for a fifth year and get a masters from the Johns Hopkins Bloomberg School of Public Health.

So I said, this is great, I get to play with the semi-pro soccer team, coach a team, and go to graduate school. I got a masters, focusing on environmental earth science, and I was also becoming more of a coach and a player.

But I had to decide: either I’m going to go on with coaching or I’m going into public health, either help young people on the soccer field or help populations. So I thought, where will I have a greater effect? where will I do the greater good? — and that’s why I went into public health.

I know my mom, who’s a middle school principal in Tabernacle, N.J., probably wanted me to play soccer forever, but unfortunately you have to give up certain things, or at least put them on the shelf until later. Fortunately now I’m coaching again, and I’m coaching two of my daughters.

They needed coaches so bad for the mini-munchkin soccer team, and my wife and I both played soccer in college and they knew we’d be interested in coaching, so our deal was, we’ll coach, but we need the 3-year-old as well as the 5-year-old to play. So the 3-year-old’s playing and she’s pretty scrappy. She doesn’t let anybody get in her way, so it’s been lots of fun.

It’s provided a good foundation for our girls. We decided we’re not so interested in whether they play soccer or not. We just want them to find something they want to do.

Princeton Health Department

I worked in the Burlington County Health Department before coming to Princeton. The county health department was great because you learn how to do things on a large scale, but what you lose a little bit of — I realized when I got to Princeton — is the idea that you can make a local impact. That’s why I love it here. You can create a program or a plan that’s going to help individuals, and you can make that impact quickly. I also love the idea of community, the idea of knowing the people you’re working with and the people in town knowing who you are.

What Princeton brings to the table, more than any other municipality, is its action, its progressive action. It’s not a sleepy town. It has such great experts in their fields that you can always find somebody who knows exactly what you’re looking for and provide the information that you need to improve health outcomes. The Board of Health here is so fantastic with their expertise that we always have someone in our corner to assist us with things we may not know.

Doctors are primarily concerned with protecting the individual, but our concern at the Health Department is with the larger community. That’s what got me into this field. I love the idea of protecting whole populations, protecting as many people as you can with the resources you have. The work of Princeton Health Department often goes unnoticed because if you don’t have outbreaks, you’re doing your job and there’s no story.

Our department also has a large health education component. Many diseases can be prevented only through lifestyle or eating habits. We put an emphasis on trying to get individuals active, trying to get them to eat healthy and take care of themselves. Chronic diseases are one of our largest concerns.

The animal control officer is also under the jurisdiction of the health department, and his main responsibility, besides picking up stray dogs and cats, is rabies control. We work closely with him. He is the officer who comes out to your house if you have a bat. He’ll take it to the laboratory to get it tested for rabies and let you know if you should go to the emergency room to get treated.

Planning, emergency planning in conjunction with the Mercer County and New Jersey Departments of Health, is around the clock for us. We try to ensure that residents will be taken care of in low probability, high-risk events like outbreaks, or anything on a mass scale.

Response Mode

If there’s a food-borne
illness outbreak at a particular restaurant, that’s when we go into response mode. We go in to inspect. We see if they’re not sanitizing properly. We see if there’s somebody working there who’s sick. We see if any of their food supply is tainted in any way.

Princeton is a town that people travel to, so there are people coming here from all over the world — almost a million visitors each year. Individuals who come into restaurants are also possible causes of spreading diseases.

When we go into response mode, it may be because we have an inclination that there’s a potential outbreak, or even a single case of a highly contagious disease, like measles. You start thinking about logistics. Who was in the area? How do we contact them? Who’s been immunized? How do we get this information out beyond our municipality? How do we ensure that this outbreak is contained with just one or two individuals?

We are a staff of five full-time employees, but when we’re in response mode it’s all hands on deck. We call in public health nurses. We call in registered environmental health specialists (food inspectors) to help us. Registrars help with media inquiries. And possibly we get the police involved if it comes to a quarantine situation to ensure the person stays put in their home. For instance, with the Ebola crisis in 2014, we had to expand the hours that public nurses were working, monitoring individuals who were potentially exposed.

Unfortunately you’re always going to have emerging new diseases brought here from around the world — some of which, like Ebola, we thought we’d never see. But that’s the mission: don’t let that disease spread. If you’re doing that, you’re on the right track. That’s at the heart of everything.

If it’s a highly contagious disease I would touch base with the Board of Health (BOH), doctors who have expertise in these diseases, or with regional epidemiologists, provided through the state health department.

We want individuals to be educated on everything — on chronic diseases, the signs and symptoms of heart attacks, strokes, breast cancer — and to make sure that people are getting proper screening for these diseases. For infectious diseases, it’s difficult to know what you have, so we want individuals to seek medical attention as soon as possible, as soon as they feel something abnormal.

The BOH and the Health Department are working together to get people to stop smoking. Smoking is the single most modifiable health decision people make.

The biggest concern in Princeton is chronic disease. Unlike infectious diseases, you don’t hear about chronic diseases all at once. They might be part of a more complicated situation. Maybe we need more walking paths, or more farmers’ markets, or more individuals to advocate for healthy eating.

We’ve been working for over a year towards public health accreditation, a set of practice standards above and beyond the state standards. We hope to complete the process in 2017. This set of standards, designed by public health professionals and the Center for Disease Control (CDC), is helping us strive for greatness when it comes to the services we provide for public health. It’s been tremendous as a map for how this department should operate.

Ultimately with public health it’s a marathon, not a quick sprint. We can’t solve all the problems at once, which, unfortunately for someone impatient like me, gets trying, but you have to stay focused on the greater good and how we can help.