Date: Nov. 4, 2002 Contacts: Christine Stencel, Media Relations Officer Andrea Durham, Media Relations Assistant (202) 334-2138; e-mail <email@example.com>
FOR IMMEDIATE RELEASE
Overhaul in Public Health Education Needed To Address Health Challenges
Who Will Keep the Public Healthy? Educating Public Health Professionals for the 21st Century, a new report from the Institute of Medicine of the National Academies, suggests specific ways to improve public health professionals' capabilities to address new and complex challenges. Public health professionals in government health departments, other health services, community agencies, and universities have a shared responsibility to prevent illness and injury and keep communities healthy. Because the extent to which the nation can continue to protect the public's health depends in large part on the quality and preparedness of its public health work force, the findings of an inadequately prepared work force are of particular concern and need to be squarely addressed. In addition, the critical role the work force plays in responding to terrorist threats heightens the urgent need to make the changes recommended in the report.
Of the more than 450,000 public health workers in the United States, only a fraction receives formal public health training. Most professionals who do earn public health degrees receive their education from schools of public health and, to a lesser extent, public health degree programs. Unlike members of virtually all other health professional groups, graduates of these programs are not certified as to their competencies. The report recommends that this issue be addressed.
Schools and programs of public health can play a significant role in advancing public health by fostering collaborations with other professional schools and degree programs, local and state health departments, and community organizations. These partnerships will facilitate the kind of interactions required to tackle complex health problems that are influenced by many factors -- social, behavioral, environmental, and cultural as well as biological causes. Public health training programs should assure that education also encompasses a number of emerging content areas critical to responding to a world changing rapidly because of globalization, medical and technological advances, and rapid demographic shifts. These areas include informatics, genomics, communication, community-based learning and research, and competence and sensitivity to cultural differences.
Recent events, particularly those of Sept. 11, 2001, highlighted the need to connect the spheres of health care and public health, both to each other and to the public. Medical care and public health gradually diverged over the past decades as the number of public health professionals with medical degrees declined. Physicians have emphasized treatment through medical intervention, while public health professionals have concentrated on prevention through methods including environmental and behavioral changes. This divergence poses a significant obstacle to the nation's ability to cope with health problems that cannot be resolved through medical treatment alone. Currently, most medical students receive little or no training in public health, and few receive advanced training. The report calls for all medical students to receive basic public health training as part of their curricula and recommends that a substantial portion -- perhaps as much as half -- obtain master's-level public health training. In addition, joint classes and other collaborations that link public health with medicine in disease prevention and chronic care should be developed.
Nurses form the single largest group of professionals practicing public health, and nursing schools and schools of public health should develop partnerships aimed at increasing effective public health practice. Schools of public health should pursue similar partnerships with other professional schools, such as law and urban planning, to encourage basic understanding of public health among all professionals whose work helps influence society's health. The report recommends that all undergraduate students have access to education in public health.
Funding of public health research also needs to be boosted to resolve the imbalance in the proportion of spending on public health research compared with biomedical research. It is estimated that only 1 percent to 2 percent of the U.S. health care budget is currently spent on population-based prevention, with a fraction of that going toward research. To facilitate the needed funding boost, the report recommends a significant increase in federal support for research in population health and primary prevention, as well as community-based research and public health systems research. Specifically, the report recommends changes in the approaches to and levels of funding by the National Institutes of Health, the Centers for Disease Control and Prevention, and the Agency for Healthcare Research and Quality.
The report was sponsored by The Robert Wood Johnson Foundation. The Institute of Medicine is a private, nonprofit organization that provides advice on health policy issues under a congressional charter to the National Academy of Sciences. A committee roster follows.
INSTITUTE OF MEDICINE Board on Health Promotion and Disease Prevention
Committee on Educating Public Health Professionals for the 21st Century
Kristine M. Gebbie, Dr. P.H.* (co-chair) Associate Professor School of Nursing Columbia University New York City
Linda Rosenstock, M.D., M.P.H.* (co-chair) Dean School of Public Health University of California Los Angeles
Susan M. Allan, M.D., J.D., M.P.H. Health Director Arlington County Department of Health Services Arlington, Va.
Kaye W. Bender, Ph.D. Deputy State Health Officer Mississippi Department of Health Jackson
Dan G. Blazer, M.D., Ph.D.* J.P. Gibbons Professor of Psychiatry Duke University Medical Center Duke University Durham, N.C.
Scott Burris, J.D. Associate Director Center for Law and the Public's Health Georgetown and Johns Hopkins Universities, and Professor School of Law Temple University Philadelphia
Mark R. Cullen, M.D.* Professor School of Medicine Yale University New Haven, Conn.
Haile T. Debas, M.D.* Dean School of Medicine, and Vice Chancellor Medical Affairs University of California San Francisco
Robert Goodman, Ph.D., M.P.H., M.A. Usdin Family Professor Health Sciences Center Tulane University New Orleans
Alan E. Guttmacher, M.D. Deputy Director National Human Genome Research Institute National Institutes of Health Bethesda, Md.
Rita Kukafka, Dr. P.H. Assistant Professor School of Public Health Columbia University New York City
Roxanne Parrott, Ph.D. Professor College of Liberal Arts Pennsylvania State University University Park
Sheila M. Smythe, M.S. Executive Vice President and Dean School of Public Health New York Medical College Valhalla
William A. Vega, Ph.D. Director Behavioral and Research Training Institute, and Professor of Psychiatry Robert Wood Johnson Medical School University of Medicine and Dentistry of New Jersey New Brunswick
Patricia Wahl, Ph.D. Dean School of Public Health and Community Medicine University of Washington Seattle
Lyla Hernandez Study Director * Member, Institute of Medicine