Miranda Hawker might just be the biggest name in Indian River County healthcare that most people have never heard of.
As administrator for the Florida Department of Health in the state’s sixth richest county, (and one of the 100 wealthiest counties in the country), Hawker could probably be in the limelight any time she wanted but she already has her hands full. In addition to running two public health service locations, (one in Vero Beach and one in Gifford), managing 135 employees, overseeing an $8 million budget, coordinating with scores of outside groups and non-profit organizations and following state directives from Tallahassee, Hawker is also charged with maintaining and improving healthcare in a county that, it turns out, is something of a statistical anomaly.
Despite its apparent wealth, Indian River County faces serious financial challenges that impact on the quality of healthcare. Using a formula known as the “Gini Coefficient,” which measures the income disparity between the wealthiest and the poorest members of a given population, the online financial network 24/7 Wall Street has determined that the Vero Beach area has the single highest level of income inequality in the entire nation.
In a county where nearly one-third of population between the ages of 18 and 64 has no medical insurance at all, upwards of 16,500 of its residents rely almost exclusively on Hawker’s agency and related non-profits for all their healthcare needs. In other words, Hawker faces the daunting task of providing medical and environmental health aid as well as communicable disease control to a growing yet financially disparate population on a budget that was cut by almost $1 million this year.
Still, the unassuming Hawker, who looks younger than her 41 years, does have experience on her side. She was appointed to her current position in 2007 and for three years prior to that she served as the department’s assistant director. Before moving to Florida in 2004, she was with the Emergency Medical Services Authority of Sacramento, CA.
Her candid response to the financial situation she faces today might surprise people. Rather than complain about state funding, Hawker says, “I feel blessed that so many of the people in this area are so generous with their donations” to the wide variety of healthcare and other community organizations working with her department.
That list includes but isn’t limited to the American Red Cross, the North Treasure Coast Chapter Boys & Girls Clubs of Indian River County, Head Start of Indian River County, the Florida Department of Children and Families, the Gifford Youth Activity Center, the Healthy Start Coalition of Indian River County, the Hospital District of Indian River County, the Mental Health Association in Indian River County, the Mental Health Collaborative, the Indian River County School District, The Redland Migrant Center Association, Treasure Coast Community Health, Inc., the United Way of Indian River County and the Visiting Nurses Association.
Hawker also singled out the “We Care” program administered through the Indian River Medical Society which, since its inception, has donated approximately $1 million in free medical care to county residents who would have otherwise been unable to afford it and to a growing dental program that offers many of those in need their first opportunity for better dental hygiene.
Now Hawker and her department are about to launch a new initiative aimed at combating childhood obesity called “5-2-1-0 Let’s Go.” The “5210” stands for eating five or more fruits and vegetables a day, limiting “recreational” screen time (computers, tablets and televisions) to two hours or less a day with one hour or more of physical activity and zero sugary drinks. Hawker plans to meet with county school principals and other officials to garner their support and then expand the program even further into the community.
County taxpayers, regardless of income levels, should be pleased to know that the monies spent by the Florida Department of Health in Indian River County likely are yielding an impressive a return on investment. According to the American Public Health Association, “investing just $10 per person each year in proven, community-based public health efforts could save the nation more than $16 billion within five years. That’s a $5.60 return for every $1 invested.”
Regardless of the financial return, the public health program that is probably nearest and dearest to Hawker’s heart is childhood immunization. “At age five, my dad was diagnosed with polio,” Hawker explained. “It was 1945 before there was a vaccine. After polio, his right leg was completely atrophied but he voluntarily participated in immunization campaigns against polio for years. He has always been a role model for me through his perseverance and determination and now we are blessed to live in a time when so many diseases are vaccine-preventable.” Through the federal “Vaccines for Children” program and the Centers for Disease Control and Prevention, Hawker’s department offers free vaccines and immunizations for county children through the age of 18.
Almost none of those things make headlines and that’s probably just fine with Hawker. The St. Olaf College graduate, who earned her master’s degree in public health at Northern Illinois University, is just too busy administering her department to worry about becoming a local health care celebrity.