Hawaii’s World

By A.A. Smyser

Thursday, October 7, 1999

Value of public health
education is unappreciated

STATE Health Director Bruce Anderson has a succinct way of putting it: Public health is concerned with the community; physicians are concerned with individuals.

This pretty well underlines our need for trained personnel in both areas. We see our doctors face to face and appreciate them. But we don't meet public health personnel in the same way. We tend to under-appreciate them.

University of Hawaii Forty or so years ago, Thomas Dewey, the Republican who narrowly missed the presidency in 1948, arrived in Honolulu from Asia and publicly thanked his lucky stars for being back in America, where he could drink the water without fear.

We tend to take safe drinking water for granted, along with clean air, and a community where streets are clean, sewers are drained and rats and mosquitoes are under control. We have public health programs to thank for it.

We sort of know that malaria, smallpox, yellow fever, cholera, polio and leprosy once were formidable menaces but are no longer. Even measles is disappearing.

We have public health to thank for it.

If a new disease or food poisoning pops up, public health personnel will work promptly to find its source. They are trying now to help us wrestle with smoking, drugs and AIDs -- all still a day-by-day threat.

Thus the controversy over saving the School of Public Health at the University of Hawaii has been of great importance. The decision to fold it into the School of Medicine could be a disaster if the medical people bury it under their priorities. It need not be if the incoming medical dean, Edwin Cadman, keeps both on his front burners. He says that's what he will do.

The terms "school" and "program" are important here. Schools have deans and issue doctoral degrees. Programs have directors, a smaller hierarchy, and usually don't award degrees higher than the master's, which are adequate for public health. Public health will become a program under Cadman.

The state Health Department has 6,000 people under its wing, most of them in public health, few of them physicians. The U.S. Public Health Service is the same.

The University of Hawaii has a strong public service obligation to supply them with trained personnel. This is as great or greater than its obligation to provide us with skilled physicians.

THE task force that made recommendations on the future of public health in the UH structure preferred to see it remain a separate school but recognized that economies can be achieved by combining the Schools of Medicine and Public Health.

Task force members had a one-hour conference call with Dean-designate Cadman, still at Yale, and were assured he wants a strong public health program.

He said having the two under the same umbrella at Yale has produced a synergy helpful to both and facilitated grant-getting. The sad truth is the UH Schools of Medicine and Public Health barely communicated with each other.

State Health Director Anderson also thinks a combined structure can provide interdisciplinary advantages over separate schools.

Amen. But I think we will need strong monitoring from the public health sector of the community just as Hawaii's future single newspaper, the Honolulu Advertiser, will need strong monitoring from groups like the Honolulu Community-Media Council.

UH School of Public Health Library
Ka Leo O Hawaii

A.A. Smyser is the contributing editor
and former editor of the the Star-Bulletin
His column runs Tuesday and Thursday.

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