Gathering Place
Nancy Partika
Public health education
-- a legacy of neglectMany public health-related headlines have been evident during the past year -- dengue fever, smallpox and anthrax scares, the epidemics of "ice" use and SARS, to name just a few. When people in a community hear about such health threats, they expect to have competent and trained public health personnel to handle these threats. What we face here in Hawaii is an impending threat -- a steadily declining lack of public health training and education to meet the demands of these turbulent times.
The University of Hawaii once had a dynamic School of Public Health, which served our state and trained professionals from our Pacific and Asian neighbors as well. Hawaii now has the unfortunate distinction of having the only school of public health in the nation to have lost its accreditation, which occurred in June 2000. Following years of systematic neglect by the state and UH administration, what was left of the school was transferred to the John A. Burns School of Medicine, shrunk into a small department with substantially narrower focus and less training capacity.
In July 2000, the UH Board of Regents approved a reorganization plan that specifically stated the goal of re-establishing the School of Public Health within five years. It also included plans to establish, at a minimum, an associate dean to lead the department back to school status, as well as four faculty positions.
Now it is June 2003, and we need to take a hard look at what little progress has been made on this plan. Two national searches for an associate dean for public health were made, one in 2001-2002 and one in 2002-2003. Two excellent candidates were tentatively offered the position. Both were turned away, purportedly due to lack of funding for the position. There will be no associate dean and, it appears, no School of Public Health for the foreseeable future.
Is it an issue of money? That seems to be only part of the problem. It appears to be more a matter of key university and state administrators lacking an understanding of what public health is, and how crucial it is in protecting and promoting Hawaii's health status. It also is clear that our university policy-makers don't have the political will to develop a dynamic public health school separate from the School of Medicine.
If we are ever to have a Hawaii School of Public Health again, we need a public health-trained leader who can engage others within the university system and the community in rebuilding the school into one worthy of Hawaii's residents and their needs. Our most recent opportunity to recruit that leader failed last month, when the candidate was told there were no funds for the associate dean position.
Hawaii is missing out on funding opportunities from national and international sources for lack of a dynamic public health training program, as a Centers for Disease Control spokesman reported last month at the Global Public Health Conference at the Hawaii Convention Center. These funding sources are going to programs and schools elsewhere, when they could be used to strengthen the public health infrastructure in Hawaii and the Pacific region.
Unfortunately, what little strategic planning that is occurring around public health training and educational needs for Hawaii is occurring among a few key UH people, with little to no dialogue with the broader public health community.
Hawaii needs a well-developed, collaborative and responsive process for rebuilding our school of public health. We need the UH Board of Regents to examine what has occurred to public health over the past four to five years and to take bold leadership action to rebuild the Hawaii School of Public Health. If UH can afford an $800,000 annual salary for football coach June Jones, it should be able to find the resources for this vital position.
Nancy Partika is a 1979 graduate of the University of Hawaii-Manoa School of Public Health. She has worked in Hawaii public health for 24 years and is the immediate past president of the Hawaii Public Health Association.