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Who Will Keep the Public Healthy?: Educating Public Health Professionals for the 21st Century
Public health professionals receive education and training in a wide range of disciplines, come from a variety of professions, work in many types of settings, and are engaged in numerous kinds of activities. One thing public health professionals have in common is a focus on population-level health. For purposes of this study, therefore, the committee developed the following definition: A public health professional is a person educated in public health or a related discipline who is employed to improve health through a population focus. Nearly all public health professionals encompassed by this definition have earned at least a baccalaureate degree.
As we begin the 21st century, public health professionals are faced with major challenges including globalization, scientific and technological advances, and demographic changes. The health of the U.S. population is increasingly affected by globalization and its accompanying environmental changes. Increased travel, trade, economic growth, and diffusion of technology have been accompanied by negative social and environmental conditions, a greater disparity between rich and poor, environmental degradation, and food security issues. There is increasing cause for concern about drug-resistant strains of emerging and re-emerging diseases (e.g., HIV/AIDS, tuberculosis, hepatitis B, malaria, cholera, diptheria, and Ebola). Along with the transmission of microbes and viruses, the increase in international trade is fostering the distribution of products associated with major health risks, for example, alcohol and tobacco.
Major challenges related to advances in science and medical technologies include important ethical, legal, and social questions. Communication technology, for example, offers increased opportunity for dissemination of health information but also requires response to the misleading or incorrect information spread through the use of this same technology. Public health informatics (i.e., the systematic application of information and computer science and technology to public health practice, research, and learning [Yasnoff et al., 2000]) offers great potential for improving our public health surveillance capacity and response but is accompanied by concerns regarding confidentiality and security of the information systems. Genomics holds the promise of helping us understand the role that genetic factors play in morbidity and mortality in the United States. However, we will need to ensure that individuals with certain genetic traits and predispositions are not discriminated against in the workplace or in obtaining insurance. While scientific advances in the biomedical field have improved the health of the public, about half of all causes of mortality in