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Who Will Keep the Public Healthy? Educating Public Health Professionals for the 21st Century (2003)
Board on Health Promotion and Disease Prevention (HPDP)
Institute of Medicine (IOM)

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. "Appendix D: Education of Public Health Professionals in the 21st Century." Who Will Keep the Public Healthy? Educating Public Health Professionals for the 21st Century. Washington, DC: The National Academies Press, 2003.

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Who Will Keep the Public Healthy?: Educating Public Health Professionals for the 21st Century

ized, these various analyses assert that public health departments are poorly staffed, and that many of the people working in them lack the specific skills, qualifications, and abilities they need to fulfill their responsibilities of protecting the public health. The faculty members of public health schools, for their part, are busy doing research, and training students to do research, but they are failing to turn out the highly educated labor pool needed to adequately staff the public health departments of the future. Phrased another way, the “theory” of public health as taught in the academy does not cohere tightly to its “practice” as performed in state and local health departments. Public health “leadership” is said to be needed to connect the fragmented pieces by taking the knowledge produced in the schools and applying it in the “laboratory” of people’s lives.

Within schools of public health, most faculty members are scientists and researchers with a Ph.D. degree. Few have any work experience outside of academia, much less in city or state health departments. Not surprisingly, they have little interest in becoming engaged with the practical work of public health agencies. Many, especially in the laboratory-centered disciplines, have little knowledge of, or interest in, politics or policy, or they regard politics as merely some distasteful contaminant of an otherwise orderly search for knowledge. Even social and behavioral scientists are often more interested in their statistical methodologies than with the messy arts of organization, advocacy, and policy-making. They shy away from the popular media, television cameras, news magazines, street demonstrations—among the various modes of informing, shaping, and challenging public opinion—as perhaps undignified and definitely distracting. Nor are they often to be found in the schools, clinics, churches, and community organizations of the decaying sections of the cities in which they work.

From the point of view of the faculty of public health schools and programs, there is little time for the multiplicity of things they are already being pressured to do. To be required to raise the best part of one’s own salary, and to write grants to cover research assistants, secretaries, students, equipment, or other research needs, focuses the mind admirably. All other activities become luxuries. To be successful in the research funding world requires associated and time-consuming commitments: to read the work of one’s colleagues, to review other people’s grant applications, to publish on a regular basis, to participate in academic and professional meetings, to have pieces of one’s time scattered across other people’s projects in case one’s own project lacks sufficient funding. None of this allows much leisure for intellectual or political activities that are not directly related to the research agenda, such as exploring the messy world of community organizations or writing for popular, as opposed to scientific, journals. It is only on rare occasions and more or less by accident that schools of public health harbor public intellectuals or effective public advocates for the public’s health.

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