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Last Updated

05 Nov 2002

Source: USA Today, November 4, 2002.

Better public health training urged

By Steve Sternberg, USA TODAY

Public health and medical schools must significantly change their approach to training students or the USA will remain unprepared for terrorist attacks and other health threats, a report out Monday says.

The nation's public health system aims to keep whole populations healthy by immunizing children, battling epidemics and helping people reduce their chronic-disease risk. But last year's terrorist attacks revealed critical weaknesses in the nation's public health safety net, including a dire shortage of experienced public health experts.

The report, called "Who Will Keep the Public Healthy: Educating Public Health Professionals for the 21st Century," examines remedies for workforce issues that emerged after 9/11. The second report, on the state of the public health system, is due out next week.

Public health training is a big part of the problem, the report says. Public health schools must shift their emphasis from training new generations of researchers to equipping their students to practice public health in states and counties around the USA.

More frontline public health experts should be recruited into teaching programs; students must also be given more opportunities to work in communities.

"That's where the real learning takes place," says Linda Rosenstock, dean of public health at UCLA and co-chair of the committee that wrote the report for the National Academy of Sciences' Institute of Medicine, a think-tank partly funded by Congress.

For their part, medical schools must expand their offerings in basic public health, the report says, asserting that half of the nation's medical students should receive advanced public health training.

"We're calling for a fairly radical change in medical school education," Rosenstock says.

She notes that medical schools train physicians to take up roles in the health-care delivery system, which consumes 97% of the nation's health budget but addresses problems underlying just 30% of the reasons people die.

"We need a new balance," Rosenstock says, with an emphasis on such factors as prevention, living and working conditions, and behavior.

Deborah Danoff of the Association of American Medical Colleges says 9/11 prompted many medical schools to enhance their public health training, and the association has begun working with the Centers for Disease Control and Prevention to hasten this process.

"The report is important," Danoff says, "because it comes at a time when people are receptive to its message."

Patrick Libbey, executive director of the National Association of County and City Health Workers, praised the report for its "forceful" advocacy of expanding practical training opportunities.