Who Will Keep the Public Healthy? Educating Public Health Professionals for the 21st Century (2003) / Chapter Skim
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6. Public Health Agencies: Their Roles in Educating Public Health Professionals
6. Public Health Agencies: Their Roles in Educating Public Health Professionals
Pages 145-167
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From page 145... ...
These discussions are followed by a series of recommendations targeted at what official public health agencies can do toward better educating public health professionals. LOCAL PUBLIC HEALTH AGENCIES Activities and Responsibilities Local health departments (LHDs)
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From page 146... ...
The education and training of the public health workers poses a difficult challenge to local health departments, one for which they will require the engagement and support of many partners, most notably the schools that educate health and public health professionals. Training and Education in Local Health Departments LHDs have serious and urgent needs for preparing new public health professionals and for upgrading the skills of current public health professionals (NACCHO, 2001~.
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From page 147... ...
(Public Health Functions Steering Committee, 1994~. The NPHPS also proposes that LHDs adopt "continuous quality improvement and life-long learning programs for all members of the public health workforce, including opportunities for formal and informal public health leadership development." They further recommend that LHDs "[pirovide opportunities for all personnel to develop core public health competencies." Many sources of education and training are currently available for local health department staff, including state government agencies, professional organizations, academic institutions, federal government agencies, consultants, other local government agencies, and in-house training (Bialek, 2001~.
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From page 148... ...
The National Public Health Performance Standards recommends that LHDs "[pirovide opportunities for public health workforce members, faculty and student interaction to mutually enrich practice-academic settings" (Essential Service 8~. Field Placements Field placement programs are probably the most frequent collaborative activity that currently occurs between local health departments and academic institutions for health professions.
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From page 149... ...
Flexible and creative approaches, such as certificate programs and public health leadership institutes, are needed to provide substantial public health training to the majority of the current LHD leadership. The many state, regional, and national public health leadership institutes that have arisen in recent years are of increasing prominence as sources of training for these upper-level LHD professionals.
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From page 150... ...
Local public health works closely with community health care providers, and all health professionals should function to some degree as part of their community's system of public health. Therefore, public health at the local level would be greatly enhanced by including basic public health education in the training of all health professionals.
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From page 151... ...
These challenges have escalated at a time when most states are dealing with budget cuts, personnel hiring freezes, and difficulty in recruiting and hiring public health professionals. Since two-thirds to three-fourths of the state health departments' budgets are personnel related, the cost of weak workforce development is magnified.
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From page 152... ...
State level public health staffs are often health professionals without public health degrees. Regarding governance, 34 state public health agencies have a state level board of health, while 22 state public health agencies do not.
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From page 153... ...
Review of the Public Health System's Progress Toward Achieving Goals and Objectives from Healthy People 2010 For the first time, these national health objectives also contain a call to improve the public health infrastructure. Specifically, states are encouraged to address the need for workforce development in areas related to public health competencies, and continuing education regarding the 10 Essential Public Health Services.
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From page 154... ...
Other budget management issues have included shifting financing for previously approved projects to cover the budget shortfall in other areas; instituting hiring freezes; redirecting special fund revenues into the general fund; boosting gaming revenues; delaying scheduled tax cuts and increasing state employee contributions to health care plans. The net effect is that, at the very least, public health departments will not have stable funding for improving population health and may in fact, lose critical resources.
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From page 155... ...
State-level public health program directors and consultants need to work in an organizational environment that provides them with the tools to manage their programs and to provide leadership to local public health agencies in that regard. Assurance of this type of learning environment requires an ongoing commitment to assessing the needs of this sector of the public health workforce and partnering with programs and schools of public health to develop programs to meet those needs.
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From page 156... ...
National Public Health Performance Standards Program The role of state health departments in assuring a competent public and personal health care workforce has been described in the National Public Health Performance Standards Program, Essential Service 8 (ensuring a competent public health and personal health care work force) which identifies the responsibilities of state public health departments as including the education, training, development, and assessment of health professionals including partners, volunteers, and other lay community health workers to meet statewide needs for public and personal health services.
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From page 157... ...
State public health agencies, working in partnership with local public health systems and the federal government, must take the lead in strengthening the quality of the public health workforce. FEDERAL PUBLIC HEALTH AGENCIES Federal agencies are important to the development of the public health workforce generally, and specifically to the education of public health professionals.
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From page 158... ...
The most recent visible activity of HRSA in public health workforce development has been the funding of 14 Centers for Public Health Training, supporting school of public health-based efforts to strengthen ties between practice and academics, offer improved distance-based continuing education, and work toward a stronger, more diverse public health workforce. The CDC's predecessor agencies were the source of early efforts to identify the public health workforce and encourage the development of public health agencies in local jurisdictions across the nation.
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From page 159... ...
The potential roles for federal agencies in developing the public health Workforce for the 21st century could take several forms, and are in the following categories: · Research · Development of academic programs · Development of faculty · Support for students · Continuing education · Technology development · Modeling Research The education of public health professionals is built on a very slender research base. There is little or no research to support advancing the M.P.H.
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From page 160... ...
Special attention should be paid to developing collaborations that can assure that the best of public health education is shared across schools, and re-invention of programs is kept to a minimum. A council parallel to the Council on Graduate Medical Education that is charged with continuous monitoring and improvement of the public health workforce development process could be an immense aid in this effort.
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From page 161... ...
Special attention should be paid to using this student support as a mechanism for increasing the racial and ethnic diversity of the public health workforce. Continuing Education While federal public health agencies have supported much technical and programmatic education for workers in federally funded public health program areas, the more recent work to make this education available via distance technology and to assure that it carries continuing education credits appropriate to the intended audience must be expanded.
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From page 162... ...
At the state level, state health departments facilitate the implementation of the Essential Public Health Services either by carrying out these services directly or by supporting the efforts of the local public health agencies. One of these essential services is to assure a competent public
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From page 163... ...
Therefore, the committee recommends that local, state, and federal health agencies: · actively assess the public health workforce development needs in their state or region, including the needs of both those who work in official public health agencies and those who engage in public health activities in other organizations; · develop plans, in partnership with schools of public health and accredited public health programs in their region, for assuring that public health education and training needs are addressed; · develop incentives to encourage continuing education and degree program learning; · engage in faculty and staff exchanges and collaborations with schools of public health and accredited public health education programs; and · assure that those in public health leadership and management positions within federal, state, and local public health agencies are public health professionals with M.P.H. level education or experience in the ecological approach to public health.
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From page 164... ...
The committee has carefully considered the rationale and feasibility of implementing recommendations to significantly enhance federal funding for both public health education and leadership development and for public health research overall, including research on population health, public health systems, and public health policy. Investment in public health education is inadequate.
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From page 165... ...
Intramural (or CDC-directed) research is carried out within its laboratories or in the field in collaboration with local and state health departments.
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From page 166... ...
However, given limited information on the full scope of the research agenda to be completed or the capacity of the public health enterprise to make rapid use of a sudden large increase, the following first efforts should be supported and their impact evaluated to identify the most fruitful areas for futher investment. Accordingly, the committee recommends that · there be a significant increase in public health research support (i.e., population health, primary prevention, community-based, and public health systems research)
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From page 167... ...
Local, state, and federal public health agencies form the backbone and the infrastructure for the public health system in the United States, and the workforce of these agencies is an essential component of that infrastructure. Public health professionals in these agencies, as well as in other organizations, must be appropriately educated to perform effectively.
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