Who Will Keep the Public Healthy? Educating Public Health Professionals for the 21st Century (2003) / Chapter Skim
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Summary
Pages 3-26
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From page 3... ...
, and local, state, and federal public health agencies, play important roles in public health education, training, research, and leadership development. This report presents conclusions and recommendations for each of these institutional settings that are directed toward improving the future of public health professional education in the United States.
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Nearly all public health professionals encompassed by this definition have earned at least a baccalaureate degree. CHALLENGES AS we begin the 21st century, public health professionals are faced with major challenges including globalization, scientific and technological advances, and demographic changes.
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THE FUTURE OF PUBLIC HEALTH EDUCATION Public health professionals have a major role to play in addressing these complex health challenges, but to do so effectively they must have a framework for action and an understanding of the ways in which what they do affects the health of individuals and populations. Several models have been proposed for understanding the forces that impact on health, that is, the determinants of health (Lalonde, 1974; Evans and Stoddart, 1994; IOM, 1999; Kaplan et al., 2000~.
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It is through this understanding that public health professionals will be able to more effectively address the challenges of the 21st
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However, the committee believes that the following eight content areas are now and will continue to be significant to public health and public health education in programs and schools of public health for some time to come: informatics, genomics, communication, cultural competence, community-based participatory research, global health, policy and law, and public health ethics. These areas are natural outgrowths of the traditional core public health sciences as they have evolved in response to ongoing social, economic, technological, and demographic changes.
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Therefore, for each of these eight emerging content areas, the committee recommends that · competencies be identified; · each area be included in graduate level public health education; · continuing development and creation of new knowledge be pursued; and · opportunity for specialization be offered. The committee believes that the progress made in understanding and incorporating these eight important areas into public health practice, education, and research will enable us, in the future, to identify other new and emerging areas that must be addressed.
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Education Only a small portion of the total public health workforce receives any formal public health education, and those who do, do so primarily through certificate programs, short courses and continuing education programs, conferences, workshops, and institutes offered by a variety of institutions and organizations. While schools of public health may play crucial roles via curriculum setting, distance learning, cross-training, and continuing education for the larger public health workforce, the committee believes that the focus of education in schools of public health should be to educate masters and doctoral level students to fill many professional
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Some, but not all, schools of public health will continue to directly educate the broader public health workforce. However, the committee recommends that schools embrace as a primary educational mission the preparation of individuals for positions of senior responsibility in public health practice, research, and teaching.
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. The committee recommends a significant expansion of supervised practice opportunities and sites (e.g., community-based public health programs, delivery systems, and health agencies)
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Doctoral research candidates should have exposure to core public health disciplines as well as the eight content areas identified earlier and researchers must be trained to understand communities and to engage in transdisciplinary research. The committee recommends that doctoral research training in public health should include an understanding of the multiple determinants of health within the ecological model.
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Finally, ethics and consideration of the relationship of human rights to health play important roles in politics and policy development. They are tools through which public health professionals can interrogate their own values, formulate policy goals, and articulate a rationale for change in policy.
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Further, the committee recommends that schools of public health actively seek opportunities for collaboration in education, research, and faculty development with other academic schools and departments, to increase the number of graduates in health and related disciplines who have had an introduction to public health content and interdisciplinary practice, and to foster research across disciplines. Access to Life-long Learning In addition to preparing new graduates in public health, there is an existing public health workforce that requires education and training, either of workers who have no previous training in the public health aspects of their positions or of those who need to update existing skills because of evolutions in the field.
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Schools' broad knowledge and expertise in the public health disciplines and educational methodology positions them to assure that comprehensive, quality public health workforce education and training is available in the region served by each school. Therefore, the committee recommends that schools of public health fulfill their responsibility for assuring access to life long learning opportunities for several disparate groups including: · public health professionals; · other members of the public health workforce; and · other health professionals who participate in public health activities.
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However, greater support for public health education is needed from state and federal governments to ensure that a competent, well-educated public health workforce is available. Public health professionals, knowledgeable about the ecological approach to health and educated in a transdisciplinary fashion, are essential to preserving and improving the health of the public.
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programs in public health institute curricular changes that and · emphasize the importance and centrality of the ecological model; · address the eight critical areas of informatics, genomics, communication, cultural competence, community-based participatory research, global health, policy and law, and public health ethics. Medical Schools Physicians have historically played a central, though not exclusive, role in insuring the health of the public.
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An ecological understanding of health and a transdisciplinary approach require physicians who are fully prepared to work with others to improve health. Therefore, the committee strongly recommends that · all medical students receive basic public health training in the population-based prevention approaches to health; · serious efforts be undertaken by academic health centers to provide joint classes and clinical training in public health and medicine; and · a significant proportion of medical school graduates should be fully trained in the ecological approach to public health at the M.P.H.
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The roles for nurses in public health practice in public health agencies, community-based practices, and elsewhere is such that the longstanding identification of the baccalaureate degree as the entry to public health practice is likely to remain the standard, even though it is often honored in the breach. Undergraduate schools of nursing will continue to be a major source of entry-level public health workers.
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Further, education directed at improving health literacy at the undergraduate level could also serve to introduce persons to possible careers in public health and, in so doing, increase the cultural diversity of the future public health professional workforce. The committee recommends that all undergraduates should have access to education in public health.
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The state health department's role in any given state is to facilitate the implementation of the Essential Public Health Services, either by carrying them out directly or indirectly through support of local public health agency efforts, and by articulating the needs of the global public health workforce to federal partners. The responsibilities of state health departments in assuring a competent public and personal health care workforce are described in the NPHPS and include regulation, education, training, development, and
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States, working in partnership with the federal government are engaged in developing multiple strategies to strengthen the public health infrastructure, including the developmental and educational needs of the public health workforce. Federal agencies' roles in public health education and research are multiple and varied including contributing to the research base that forms the content of education, testing educational approaches, helping schools develop infrastructure, supporting faculty development, and providing funding for students.
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Therefore, the committee recommends that local, state, and federal health agencies · actively assess the public health workforce development needs in their own 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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Therefore, the committee recommends that federal agencies provide increased funding to ships; · develop competencies and curriculum in emerging areas of practice; · fund degree-oriented public health fellowship programs; · provide incentives for developing academic/practice partner· support increased participation of public health professionals in the education and training activities of schools and programs of public health; especially, but not solely, practitioners from local and state public health agencies; and · improve practice experiences for public health students through support for increased numbers and types of agencies and organizations that would serve as sites for practice rotations. In terms of research funding, comparatively few resources have been devoted to supporting prevention research, community-based research, transdisciplinary research, or the translation of research findings into practice.
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for population health and related areas; and · there be a redirection of current CDC extramural research to increase peer reviewed investigator-initiated awards in population health, prevention, community-based, and public health policy research, reallocating a significant portion of current categorical public health research funding to competitive extramural grants in these areas. Educating public health professionals to effectively respond to the new and emerging challenges requires funding support.
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Public health professionals' education and preparedness should be of concern to everyone, for it is well-educated public health professionals who will be able to effectively shape the programs and policies needed to improve population health during the coming century. If we want high quality public health professionals, then we must be willing to provide the support necessary to educate those professionals.
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