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Organizing public health education towards the patient

By Laura Siminoff

Earlier this year, I attended the Association of Schools and Programs in Public Health (ASPPH) annual meeting.  The meeting reminded me that we continue to struggle with how to keep people healthy and improve their health when they become ill.

As a society, we have invested huge sums of money in medicine and yet we still only rank dead last in health status for our citizens according to a Commonwealth Foundation study of developed countries.  

If you need and can afford high tech care for cancer you are in luck; but if, like many of our citizens, you are challenged by a lack of exercise, poor diet, an environment that makes your child’s asthma worse, or perhaps you or a family member has hypertension or diabetes, then you are better off being a citizen of Canada, France or Switzerland.

Why is that?  We spend more money on medical research than any other country in the world.  However, our main source of funding, the National Institutes of Health, spends only 7% of their research budget on prevention research and probably no more than another 7% on the social and behavioral aspects of the delivery and use of health care. Lobbyists for big Pharma and big medicine dwarf the voices for spending money on relatively low cost behavioral and life style changes that could seriously change the trajectory of many people’s lives.

I know I am not alone in these concerns. And, I know I am not alone in wanting to change these statistics. 

Most public health schools are organized in the same way healthcare in this country is organized. It is siloed. Faculty who are interested in exercise to prevent heart disease rarely speak with researchers who are interested in exercise and cancer.

As schools of public health, our charge to train the next generation of the nation’s public health and welfare workforce is vital.  We need to work together as a unit – as epidemiologists, nurses, social workers and therapists to effectively teach students and effectively prevent and treat disease.

While at the ASPPH meeting, I found some hope in what is happening in academia. Three of my colleagues - Jennifer Ibrahim, Jess Boyer and Mary Sinnot – discussed how a team approach to education can train incoming students across the disciplines (health administration, physical therapy, nursing, social work, therapeutic recreation, occupational therapy, public health, communication sciences & disorders, kinesiology) to see the ‘big picture’ as practicing clinicians and researchers.

It is through this collaboration that I believe we can really start to change the trajectory of the nation’s health. Hopefully, in the future, trans-disciplinary research, education and practice will not be something we make an effort to do, but something that comes as naturally as taking a breath.