We must create a `new public health' to tackle looming challenges

September 26, 2007|By Robert S. Gold

Our nation faces daunting health challenges that call for new public health strategies.

A 2003 report from the Institute of Medicine, "Who Will Keep the Public Healthy?" concludes, "We are now facing problems that no one has seen before." It predicts that all cities and states in the 21st century will face changing disease patterns linked to climate change. The toll of poor lifestyle choices will mount. Alarming statistics on obesity, especially childhood obesity, Type 2 diabetes and mental health problems, along with the aging of the baby boomers, point to an even greater load for our health care delivery systems.

The good news is that efforts to create a "new public health" have begun, and universities - including, starting today, the University of Maryland, College Park - are helping to lead this major re-engineering project.

A variety of alarming health trends are converging at a time when we face a shortage of trained public health workers. The American Public Health Association estimates that half of federal public health workers and one-quarter of state-level workers will retire in the next five years. Even today, one study estimates that 80 percent of public health workers lack full training in their fields.

The "new public health" recognizes that biomedical approaches cannot solve all health problems. We must also address individual lifestyles, social and community influences, living and working conditions, as well as educational, environmental and cultural factors and government policies.

Universities, through their research and training programs, are helping redirect the public health profession to focus on strategies that actively promote health and healthful lifestyles, not just prevent diseases and health problems. Many of the causes of premature death are preventable. A close collaboration between the university and health systems is essential for the success of this redirected focus.

Starting today, Maryland - and the Mid-Atlantic region - will have its first school of public health based at a public university. As dean of the University of Maryland School of Public Health in College Park, I believe that this new school, in collaboration with the state, will be a major force in the creation of models for the nation's new public health.

Service to Maryland is our core mission as a public university, and will be reflected in all of our training, research and outreach efforts. We will deliver a work force to Maryland and the world ready to address the complexities of the public's health through scientific discovery, practice, education and policy development.

We are grounded in the philosophy that the nation must close the gap between science and its application to eliminate health disparities - racial, ethnic, age-related and socioeconomic. That will be one of the primary goals of our new Herschel S. Horowitz Center for Health Literacy, the first of its kind in the nation. We will translate research into practice so that health care workers, policymakers and the public can work together to improve health.

We can draw on the resources of this Top 20 public research university to look at the many issues that shape public health, from the environment to public policy to engineering and the biosciences. We will expand our programs in public and community health, family science and the study of genetic and environmental factors that affect health.

Collaboration with other schools and universities, state and local health departments, professional organizations and the public is pivotal to achieving our mutual goal of health for all. We must work together to bring the state and the nation a step closer to creating a new public health and preparing the next generation of public health leaders.

Robert S. Gold is the dean of the School of Public Health at the University of Maryland, College Park. His e-mail is rsgold@umd.edu.

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