NET HEALTH: Prevent – Promote – Protect

by Terrence Ates

The City of Tyler and the Texas Department of Health organized the Tyler-Smith County Health Unit in 1936. The local health department was expanded to cover all cities within Smith County in 1994 through a cooperative agreement established by Smith County and the City of Tyler. In 2003, due to our expansion to other East Texas counties, and to better reflect our areas of service, our name was changed to Northeast Texas Public Health District, also known as NET Health.

NET Health is governed by a nine-member Board of Directors whose membership is composed of appointments approved by the Smith County Commissioners Court, the City of Tyler, the Smith County Medical Society, and the Smith County Dental Society. Since 2006, our Chief Executive Officer has been George Roberts, who previously served as a hospital administrator in East Texas for several decades.

Approximately 30 years have been added to the average lifespan of American citizens since 1900, and 25 of those years are attributed to Public Health initiatives such as clean water, safe food, and vaccinations against preventable diseases. Our mission is to
Prevent Illness, Promote Health, and Protect Our Community. 

It is a misnomer that ‘Public Health’ is only for the poor. Public health affects everyone every day, regardless of your physical address or your income, regardless of your family size or your ethnicity. 

A Tylerite’s life is continually impacted by NET Health through our ability to provide infant, childhood, and adult immunizations; through meals that are eaten at Tyler restaurants, through your use of a public pool or of a splashpad; through your use of water that is supplied to your residence; through milk that is purchased at your favorite grocery store; and through other daily activities that may have been made possible through the work conducted by a NET Health employee.


Public health affects everyone every day, regardless of your physical address or your income, regardless of your family size or your ethnicity. The most recent large-scale example of a service that demonstrates the first tenant of our mission statement was during our 6-month residency as the final performing act at the Harvey Hall Convention Center. The tune of that unmelodious concert was set to tempo by the pandemic and the performers of that free NET Health concert were the orchestral community partnerships that included employees of our NET Health Immunizations Department; our NET Health Public Health Emergency Preparedness Department; faculty and students from the TJC School of Nursing, UT Tyler School of Nursing, and UT Tyler School of Pharmacy; the City of Tyler; and countless individual community volunteers who assisted NET Health’s ability to administer over 60,000 COVID vaccines that literally prevented the continued onset of disease spread. 

In 2004, the Texas Legislature updated the Texas Administrative Code to include vaccine requirements that apply to all children and students who are entering, attending, enrolling and/or transferring to child-care facilities, public or private, primary or secondary schools or institutions of higher education. The vaccine requirements were adopted as a statewide control measure against communicable disease, so that every child in the State of Texas shall be vaccinated against vaccine-preventable diseases caused by infectious agents, in accordance with the State of Texas’ Recommended Immunization Schedule. The month of August is nationally observed in the United States as Back to School Month, which coincidentally, or maybe on purpose, connects with National Immunization Awareness Month. 

Our local and state guidance is further supported by the Centers for Disease Control and Prevention (CDC), who possess evidence-based information that the simplest and safest protection against many communicable diseases is through vaccination. Our Immunizations Clinic is based at 815 North Broadway Avenue in Tyler. Our staff of nurses, public health technicians, billing clerks, and customer service associates strive to immunize anyone through their mobile vaccination clinics that are provided at church events, school campuses, day cares, health fairs and clinics set up for employees at local businesses. 

NET Health also investigates and treats active cases of Tuberculosis (TB), an active communicable disease that requires persistent monitoring and preventive treatment. NET Health works with jails, school districts, and multiple community-based agencies to identify and treat patients, as we also work closely with the Texas Department of State Health Services (DSHS) and with the UT Tyler Health Science Center to coordinate care for TB patients in Smith County. As a preventive measure, NET Health offers routine testing for TB to the general public, which is available each weekday at our Immunizations Clinic. Testing is conducted with convenient skin tests for persons who may be at a higher risk of developing disease, who have been in contact with a known TB patient, or whose job duties may increase their potential occupational exposure to Tuberculosis.

The prevention of disease spread is also a cornerstone service of our Regional Laboratory. At your residence, municipal water is used when brushing your teeth, drinking a glass of water, bathing yourself, preparing a healthy home-cooked meal, and washing your dishes. The municipal water is clean and safe for use thanks to the daily activities of the technicians and office support staff within our NET Health Regional Laboratory.

The water that flows through your residential pipes may have been sampled by the NET Health Regional Laboratory. Whenever you may hear of an East Texas community or municipality that is under a Boil Water Notice, our Regional Laboratory is a highly utilized facility for cities that send samples of their municipal water for analysis to ensure safety of the public water supplies for regular testing and for boil water notices. Our lab technicians also perform regulatory milk analysis of dairies throughout Northeast Texas and of milk and milk products that are sold at stores to ensure the public’s safety.  The NET Health Regional Laboratory is one of only seven certified milk laboratories in the State of Texas. In a totally separate area of our Regional Laboratory, we process hundreds of samples each month from local doctor’s offices and public health clinics throughout East Texas who trust our Regional Laboratory to analyze clinical samples to test for the presence of Syphilis, Gonorrhea, and Chlamydia that may be present in our community. 


The World Health Organization is frequently referenced as a sound source of definitive data. They explain that the term “health” is not just “… the absence of having a disease but that it is a complete and whole feeling of physical, mental, and social wellbeing.” Multiple health-focused organizations use the synonym of “wellness” to where the sum total of your current health-related experiences is more positive, and that higher levels of perceived wellness relate to higher feelings of being healthy. Similar to many educational tenets, the state of being a healthy person requires continual education, ways to measure comprehended knowledge, and the ability to apply the learned lessons in everyday life. 

These basic lessons of lifelong health education are a cornerstone activity of our Women Infants and Children (WIC) Program. Two WIC clinics are in Tyler: one located at 815 North Broadway Avenue, and the other on East Amherst Drive. NET Health also operates WIC clinics in Canton, Athens, Gun Barrel City, Palestine, Jacksonville, Alto, Carthage, Henderson, Jefferson, Marshall, Daingerfield, Mount Pleasant, Gilmer, Lindale, Quitman, Sulphur Springs, Linden, Atlanta, and Clarksville.

Every month, approximately 26,000 pregnant women, new mothers, and new fathers receive services from our WIC Program, which is available to any parent, stepparent, legal guardians, and/or foster parent of infants and children under the age of five. Women who are pregnant are also eligible to apply, as are women who have had a baby in the past six months and women who are breastfeeding a baby under one year of age. Even if you are actively employed and work full-time, whether or not you have health insurance, your annual income may qualify you for WIC services. 

Although WIC has been traditionally a mother-focused health service, NET Health has launched a focused initiative to empower fathers to also attend their child’s WIC appointment utilizing our male employees to serve as ambassadors and role models for fathers to be more active and present for their child(ren)’s WIC appointments. Our Peer Dads also provide free educational classes to soon-to-be first-time fathers through our “Ready for Baby” classes, and to fathers of newborns and infants in our free “Understanding Fatherhood” classes. On the third Thursdays of each month, our Peer Dads invite the attendees of all our father-focused classes to our “Dads Huddle” meetings, where ‘how to dad’ is the topic of discussion. 

The most renowned service provided by WIC is the free nutrition assistance made available by access to free groceries that are available for WIC clients to obtain at local grocery stores through the Supplemental Nutrition Assistance Program (SNAP). Food items that are eligible for SNAP Benefits include most fruits and vegetables, beans and legumes, cereals, oatmeal, tortillas, canned fish, soymilk, tofu, yogurt, cheese, eggs, and whole-grain breads—just to name a few. Each of our twenty WIC clinics also have Breastfeeding Peer Counselors who empower mothers and educate the entire family about the importance of breastfeeding for the child and for the mother, as expressing breastmilk offers multiple benefits to the development the child’s immune system and physical maturation while also benefiting the mother’s physical, mental, and emotional wellness.

Every person who was born within the city limits of Tyler has an instantaneous connection with our Vital Statistics Department, for a Tylerite’s first breath qualifies you to have your birth certificate registered within the State of Texas. Birth certificates can be printed and provided to you by our Vital Statistics Department that is located at our central office building at 815 North Broadway Avenue in Tyler.

As we enjoy the life cycle, the promotion of living a healthy lifestyle evolves into the avoidance of developing a personal health situation that may have been prevented through a healthy diet, daily physical activity, and adequate sleep . . . but it gets a little more complicated than that as we age. The lifelong pursuit of the absence of disease that is accompanied by the physical, mental, and social wellbeing may be genetically inherited by some and behaviorally inherited by others. Since 2013, NET Health has repurposed the previous Tyler Fire Station on the Frankston Highway inside Loop 323 to become the nationally recognized community resource known as The Center for Healthy Living. 

For uninsured women, our Breast and Cervical Cancer Services Program assist in the application process for women to become scheduled with a local medical provider for a free mammogram and/or a free Pap smear. The CommUNITY Cares Program allows anyone without health insurance to become scheduled for a wellness exam at a local health clinic, providing the opportunity for the uninsured person to have a dedicated primary medical care home. One of the major goals of the CommUNITY Cares Program is that people are not utilizing the emergency room as their primary medical care location, saving time and money for the individual, for our local hospital systems, and for our community.

One out of every eight Tylerites has Type-2 Diabetes, high blood pressure, high cholesterol, or any combination of at least two chronic diseases. As mentioned earlier, public health affects everyone every day, regardless of your physical address or your income, regardless of your family size or your ethnicity. Our Community Health Workers have provided individual counseling sessions and group education classes at retirement communities, golf recreation centers, large and small businesses, health fairs and community events.  These free events teach how easy it is to live a healthy life and to also improve their health numbers to the point where they are no longer diagnosed with that health condition. One of the reasons that The Center for Healthy Living is such a unique model for community health interventions is that we have clients who have been able to completely stop taking medications that were prescribed for their high blood pressure or for their Type-2 Diabetes. 

The promotion of healthy living is a sentiment shared by employees within all our departments, as we strive toward our vision of optimal health for all of Northeast Texas. The employees that comprise our eight departments of public health service are actively involved in numerous community coalitions and municipal partnerships, such as East Texas Human Needs Network, Fit City Tyler, Healthy Me Healthy Babies Coalition, Leadership Tyler, the local chapter of the March of Dimes, Northeast Texas Community Health Workers Coalition, Northeast Texas Immunization Coalition, Piney Woods Regional Advisory Council, School Health Advisory Committees (SHAC’s), Texas Environmental Health Association, and United Way of Smith County. The totality of NET Health’s involvement within the community is one of the many contributing factors for our organization to have been recognized recently by the East Texas Council of Governments as their Regional Corporate Citizen of the Year, and to have been recognized by the Tyler Area Chamber of Commerce as its most recent recipient of the Large Business of the Year Award. 


Last year, the Texas State Comptroller estimated that Tyler residents over the age of 18 purchased more than 15,000,000 meals/snacks in food establishments inspected and regulated by NET Health, equating to the statistic that the average Tylerite purchases at least five meals/snacks each week from a food establishment that operates within the City of Tyler. For the City of Tyler alone, and not including food establishments in other cities within Smith County, NET Health conducts inspections and analyzes data collected from 1,400 food establishments (i.e., traditional brick-and-mortar restaurants, food trucks, pushcarts, and associated types of mobile food units) that have an official food permit on file with our Environmental Health Department. 

In conjunction with the oversight of those permanent food establishments, there are an average of 400 temporary food events per year that occur in Tyler and the sanitarians within our Environmental Health Department educate the coordinators of these one-time events. These events include public events at parks or meals provided for sale by a community organization. Our staff provides information about effective solutions for safe operation that comply with the Texas Health and Safety Code’s minimum regulations. 

In addition to food-related environments, our sanitarians also conduct inspections and analyzes water samples collected of the 180 public pools, splashpads, and public water features in Smith County that are open for public use at hotels, apartment complexes, and municipal recreation facilities. Similar to the process of municipal water testing that is performed by our Regional Laboratory, the testing of water samples from public pools is very important to ensure adequate levels of sanitation are maintained to prevent known water-borne pathogens from being transmitted. Our Environmental Health Department conducts annual inspections of over 130 childcare facilities, over 60 foster homes, as well as any other facility that is required to have a health inspection to evaluate the basic Environmental Health Safety of the facility. 

Protection is also a cornerstone activity for our Department of Public Health Emergency Preparedness as they work to protect the citizens of Tyler, Smith County, and of six neighboring East Texas counties against community emergency situations such as a severe weather event or an act of bioterrorism. The pandemic is the most recognizable example of the 24/7/365 performance of our epidemiologists within Disease Surveillance. This department is a vital resource to businesses, nursing homes, residents of congregate settings, law enforcement, the medical community, emergency management, emergency medical services, and elected leaders throughout East Texas. We also protect our community against West Nile, H1N1, Tuberculosis, Zika, Whooping Cough, and every other major threat to public safety. 

Our Emergency Preparedness staff cover the counties of Smith, Gregg, Wood, Rains, Van Zandt, Henderson, and Anderson. This department is composed of coordinators that partner with law enforcement, medical community, emergency management, emergency medical services, and municipal leaders within their respective counties to ensure readiness to respond to any community emergency or any threats to the health of our community. Tyler residents were witness to the well-established partnership between NET Health, the City of Tyler, and Smith County during the operation of the Emergency Operations Center (E.O.C.) during the pandemic. The presence of the steadfast work performed by our Emergency Preparedness County Coordinators is also evident whenever coastal residents may evacuate into East Texas due to a gulf storm, or whenever there is a strong windstorm or a large amount of rainfall within a short amount of time.


The delivery model of medical care is for the provider to care for one individual person at a time, whereas public health has to be attuned to the needs for entire populations of individuals at the same time. When Public Health does its job well, this indicates the presence of a strong public health system in our community. People are protected and the transmission of disease is controlled. 

As your family prepares for your child(ren) to return for their upcoming school year, remember that NET Health not only assists with their necessary age-appropriate immunizations, but we also provide birth certificates for students who are enrolling at a new school, new school district, and/or a college or university. The next time you eat at your favorite restaurant or your favorite food truck, remember that the food being served was reviewed for safety by NET Health. The next time you turn on your faucets at home, remember that NET Health ensures the cleanliness and safety of the water. The next time you take your children or grandchildren to a splashpad or to a public pool, remember that NET Health analyzed the safety of the water. Public health affects everyone every day, regardless of your physical address or your income, regardless of your family size, regardless of your ethnicity . . . and regardless of whether you are a citizen or a visitor to the Tyler area. We are Public Health. We are NET Health.

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