CELEBRATING TWENTY YEARS IN “The Future of Public Health” OPPORTUNITIES FOR TOMORROW’S...

CELEBRATING TWENTY CELEBRATING TWENTY YEARS IN “The Future of YEARS IN “The Future of

Public Health” Public Health” OPPORTUNITIES FOR OPPORTUNITIES FOR

TOMORROW’S TOMORROW’S LEADERSHIP LEADERSHIP

Ned Baker Annual Lecture, NALBOH

Bowling Green, Ohio

April 3, 2008

CELEBRATING TWENTY CELEBRATING TWENTY YEARS IN ‘THE FUTURE OF YEARS IN ‘THE FUTURE OF

PUBLIC HEALTH’PUBLIC HEALTH’

Hugh H. Tilson MD, DrPHPublic Health Leadership Program UNC School of Public Health and Member of the Panel, IOM, 1988

But FIRST … a word about But FIRST … a word about the Health of the Public in the Health of the Public in

the 21st Centurythe 21st Century“The Future of the “The Future of the

Public’s Health” 2003Public’s Health” 2003

A Report from the Institute of Medicine Follow-up Study of the 1988

“Future of Public Health” and its implications for NALBOH’s Public

Health Leadership

Committee on Assuring the Health of the Public in the 21st Century

INSTITUTE OF MEDICINE

OF THE NATIONAL ACADEMIES

THE FUTURE OF

THE PUBLIC’S

HEALTH

in the 21st Century

What’s “ASSURING”??What’s “ASSURING”??Whaddya’ mean “keeping Whaddya’ mean “keeping

pace”? In THIS mess? pace”? In THIS mess?

We regret that the We regret that the program … originally program … originally scheduled for this time … scheduled for this time … could not be CANCELLED!! could not be CANCELLED!!

The National Academies

The National Academy of Sciences (1863)

The National Academy of Engineering (1964)

The National Research Council (1916)

The Institute of Medicine (1970)

Why a new study about Why a new study about the future of public health?the future of public health?

NOT BECAUSE THE ‘OLD’ REPORT WAS WRONG


NOT BECAUSE THE ‘OLD’ REPORT WAS WRONG …IN FACT, IT IS ‘EVERGREEN’!!

IOM’s LANDMARK REPORT ON IOM’s LANDMARK REPORT ON “THE FUTURE OF PUBLIC “THE FUTURE OF PUBLIC

HEALTH” 1988HEALTH” 1988

CELEBRATING TWENTY CELEBRATING TWENTY YEARS OF PROGRESS: YEARS OF PROGRESS:

1988-20081988-2008


NOT BECAUSE THE ‘OLD’ REPORT WAS WRONG … IT IS

‘EVERGREEN’!! And DEFINITELY worth a careful look

The LANDMARK report on the The LANDMARK report on the “Future of the Public Health” “Future of the Public Health” IOM 1988: BACKGROUNDIOM 1988: BACKGROUND

--The Swine Flu fiasco of 1976--The Model Standards for Community

Preventive Health Services weak response--The inability of the local infrastructure to

respond to the Model Standards--The crumbling of Federal support--The politicization of the Federal Public

Health leadership

The 1988 PanelThe 1988 Panel

21 of the Brightest and the Best (plus me)All the right domains representedAll the public health professionsElected officialsSuperb high level professional staffingAdequate resources … Kellogg, CDC,

HRSA funding

The 1988 Report: the The 1988 Report: the approachapproach

“check your assumptions at the door”Used classic social science methods … broad

fact finding, literature reviews, expert testimony, and field site visits

Asked: what is your definition of public healthUsed: “tracers”: what was the problem, what

did you do about it, who made it happen?

1988: The Big News1988: The Big News

“… this nation has lost sight of its public health goals and has allowed the system of public health activities to fall into DISARRAY!”

1988: the critical re-1988: the critical re-conception of public healthconception of public health

“The committee defines the mission of public health as fulfilling society’s interest in assuring conditions in which people can be healthy”

“The committee finds that the core functions of public health agencies at all levels of government are assessment, policy development, and assurance”

1988: the Core Functions1988: the Core Functions

Assessment: … regularly and systematically collect, assemble, analyze, and make available information on the health of the community …

Policy Development: … Agencies must take a strategic approach, developed on the basis of a positive appreciation for the democratic political process

1988: The core functions1988: The core functionsAssurance: … assure their constituents that

services necessary to achieve agreed upon goals are provided … encouraging actions by other entities …. Requiring such action through regulation, or by providing services directly

… a set of high-priority personal and communitywide health services that governments will guarantee to every member …

IOM 1988: RecommendationsIOM 1988: Recommendations

States: “… are and must be the central force in public health”

Localities: “no citizen from any community, no matter how small or remote, should be without identifiable and realistic access to the benefits of public health protection, which is possible only through a local component of the public health delivery system.” “the AGPALL” concept

1988: Fulfilling the 1988: Fulfilling the Government Role: Government Role:

Implementing Implementing Recommendations Recommendations

Statutes: … reform; delineate responsibilities and authorities and a core set of functions

Organizational Structure: … an identifiable state department of public health … state health council .,.. Establish standards for local public health functions

1988: Organizational Structure1988: Organizational Structure

Localities: “… the larger the population served by a single multipurpose government, as well as the stronger the history of local control, the more realistic … promote local accountability

1988: Organizational Structure1988: Organizational StructureLocalities: “… the larger the population served

by a single multipurpose government, as well as the stronger the history of local control …… clear focal point: “where the scale of local government activity permits, localities should establish public health councils to report to elected officials on local health needs and on the performance of the local health agency.”

(NOTE TO NALBOH … what happened THREE years after this recommendation?)

1988: Special linkages1988: Special linkages

Environmental healthMental HealthSocial ServicesCare of the indigent: “… until adequate federal

action is forthcoming, public health agencies must continue to serve …to the best of their ability, the priority personal health care needs of the uninsured, underinsured, and Medicaid clients.”

1988: Strategies for Capacity 1988: Strategies for Capacity BuildingBuilding

Technical: uniform data set; Institutional home for new knowledge; research

Political: relationships with elected officials; competence in community relations; working partnerships and support among local, state, and national medical and professional societies …

1988: Strategies for Capacity 1988: Strategies for Capacity BuildingBuilding

Managerial: … training … on managerial and leadership skills; demonstrated management competence … should be a requirement; salaries and benefits

Programmatic: … more emphasis on “factors that influence health-related behavior …”

Fiscal: … Fed to State and State to local, with incentives and sanctions

1988: Education for Public 1988: Education for Public HealthHealth

Schools … firm practice links; resources to governments; students “an opportunity to learn the entire scope of public health practice”; research … applied and implementation; full advantage of other faculties; full support to other faculties

Education programs … should be informed by comprehensive and current data on public health personnel…”

Why a new study about Why a new study about the future of public health ?the future of public health ?

2000: IOM commissioned a systematic review of progress as part of its commitment to follow-through.Progress was dramatic on every front. However, challenges and frustrations abounded as well.IO

Why a new study about Why a new study about the future of public health ?the future of public health ?

IOM commissioned a systematic review: PROGRESS is IMPRESSIVE Conceptualization: The public health working group and the ten essential servicesOrganization: NACCHO, NALBOH, Council on LinkagesWorkforce: PHLI, Management Academy

IO

Why a new study about Why a new study about the future of public health in the future of public health in

2000-2003?2000-2003?Still, due to the rapidly changing (“flat”) world, public health systems were under greater stress than ever before

Additionally, these changes bring increasingly diverse demands, expectations, opportunities, and resources for public health

Oh, yes … and then there’s the MONEY $$$$$$$$$$$$$$$$$$$

WE interrupt this program WE interrupt this program for the following for the following announcementannouncement

Why a new study about Why a new study about the future of public health in the future of public health in

2003?2003?

And then came September 11th …

And the Anthrax attacks that followed … that changed ‘everything’… and for the IOM Committee, the urgency for a report to galvanize to concerted action was CLEAR

Why talk about a twenty year Why talk about a twenty year old and a five year old study old and a five year old study

about about the future of public health the future of public health

HERE/NOW?HERE/NOW?…because the Nation and States need help from our leadership …a.k.a. YOU !

But first...But first...

a word from our sponsors!

The 2003 study sponsorsThe 2003 study sponsors

Centers for Disease Control and Prevention (CDC)

Substance Abuse and Mental Health Services Administration (SAMHSA)

Health Resources and Services Administration (HRSA)

National Institutes of Health (NIH)

Office of the Secretary, Assistant Secretary for Planning and Evaluation (OS/ASPE)

Office of Disease Prevention and Health

Promotion (ODPHP)

Assuring the Health of the Public Assuring the Health of the Public in the 21st Centuryin the 21st Century

Who?

The 2003 CommitteeThe 2003 Committee

Jo Ivey Boufford Christine Cassel Kaye Bender Lisa Berkman JudyAnn Bigby Thomas Burke Mark Finucane George Flores Lawrence Gostin Pablo Hernandez

Judith Lave John Lumpkin Patricia Peyser George Strait Thomas Valente Patricia Wahl Gail Warden Hugh Tilson (Liaison) George Isham

(Liaison)

Assuring the Health of the Public Assuring the Health of the Public in the 21st Centuryin the 21st Century

Who?

What?

When?

Where?

How?

Addressing the charge required...JUST WHAT YOU REQUIRE TODAY …

MethodologyMethodologyLiterature review on all relevant topics

Hearings and expert testimony at Committee meetings

Input from the Committee’s Liaison Panel and from the general public

Qualitative and quantitative data from Federal, state, and local public health systemsState and local community organizationsNational and professional organizations

Site visits

Futures visioning and scenario building

Today’s forecast is limited by Today’s forecast is limited by lack of vision …. lack of vision ….

Futures visioning and Futures visioning and scenario buildingscenario building

The committee examined the drivers, or the forces that are likely to shape the future, and used “visioning” to generate scenarios, or potential realities for which public health must be prepared.

Futures visioning and Futures visioning and scenario buildingscenario building

The committee ascertained the drivers, or the forces that are likely to shape the future, and used visioning to generate scenarios, or potential realities for which public health must be prepared. .. AND a great way for YOU to LEAD, too”

Some important “drivers” of Some important “drivers” of population healthpopulation health

Globalization

Changes in the

environment

A social and political environment that prioritizes health

Disparities in health status and access to

care

Advances in biotechnology and

information technology

Infectious disease threats


Globalization

Changes in the

environment



care




Including MAN-MADE ONES!!

Public health is preparing for whatever comes next.


Globalization

Changes in the

environment



care



glumbert/media/shift


Including MAN-MADE ONES!!

WWW.NAP.EDU



THE FUTURE OF

THE PUBLIC’S

HEALTH

in the 21st Century

The Context for the ReportThe Context for the Report

1988 report is ‘evergreen’ and there is GREAT National Health Achievement in the 20th Century BUT …

US falling short in international comparisonsPoor return on investment in healthConcern about the government public health

infrastructure’s ability to meet future health challenges, both local and global

Background in the ReportBackground in the Report

Health = Public GoodGovernment has fundamental, statutory

duty to assure the health of the public


Health = Public Good“Without Health there can be no happiness”

(attributed to Thomas Jefferson IOM p xi)Government has fundamental, statutory

duty to assure the health of the public


Health = Public Good Government has fundamental, statutory duty to

assure the health of the public, BUT … Government cannot do it alone Need for inter-sectoral engagement in partnership

with government (the 1988 report mission statement is indeed EVERGREEN!)

Health = social goal of many sectors and communities

The root causes of ill health must be addressed by many outside the public health system

The Committee’s ConclusionThe Committee’s Conclusion

An inter-sectoral public health system is needed

In 1988 report, public health refers to the “organized efforts of society, both government AND OTHERS, to assure conditions in which people can be healthy”

THIS report elaborates on the efforts of the other potential public health system actors.

The Committee’s VisionThe Committee’s Vision

The committee adopts as its vision the vision of Healthy People 2010: Healthy People in Healthy Communities

NOTE: The committee explicitly elected NOT to ‘re-discover the wheel’ … a good principle to keep the pace!

MAJOR opportunities for MAJOR opportunities for NALBOH from the 1988 and NALBOH from the 1988 and

2003 IOM Reports2003 IOM Reports The SYSTEM components and their roles The TEN Essential Services Core Competencies Public Health SYSTEM Performance Standards Certification Accreditation

Really embracing the Really embracing the “SYSTEM” as proposed by the “SYSTEM” as proposed by the

1988 report1988 report

The Committee’s Conception: The Committee’s Conception: The Public Health SYSTEM!!The Public Health SYSTEM!!

The Official Public Health Agency Infrastructure

The Community

The Private Sector/Industry

The Medical Care System

The Media

Academia

What is the Public Health What is the Public Health System?System?More than just the

public health agency

“Public health system” – All public, private, and

voluntary entities that contribute to the delivery of public health services within a jurisdiction.

Assuring the Assuring the Conditions for Conditions for

PopulationPopulationHealthHealth

Employersand Business

Academia

GovernmentalPublic Health Infrastructure

The Media

Healthcare delivery

system

Community

(IOM, 2003)

The Public Health System …The Public Health System …

… GREAT progress since 1988…”Despite this progress, the Committee

found that in many important ways, the public health system that was in disarray in 1988 remains in disarray today.”

The Public Health System …The Public Health System …

And so how can NALBOH’s members help public health agencies to gain the status, recognition, and respect to lead the system while we must “run the business…”?

NALBOH in the lead: putting NALBOH in the lead: putting the essential in “ESSENTIAL the essential in “ESSENTIAL

SERVICE”??SERVICE”??

The Essential Public Health The Essential Public Health Services building on 1988Services building on 1988

1. Monitor health status

2. Diagnose and investigate health problems

3. Inform and educate

4. Mobilize communities to address health problems

5. Develop policies and plans

6. Enforce laws and regulations

7. Link people to needed health services

8. Assure a competent health services workforce

9. Evaluate health services

10. Conduct research for new innovations

THE TEN Essential ServicesTHE TEN Essential Services

Monitor health status …Diagnose and investigate health problems ..Inform, educate and empower people …Mobilize community partnerships …Develop policies and plans that ….“My Day Is Made Pushing …”

THE TEN Essential Services THE TEN Essential Services (cont)(cont)

Enforce laws and regulations … Link people to needed personal health svcs.. Assure a Competent public health AND personal

health care workforce Evaluate effectiveness, accessibility and quality of

personal and population based Services Research for new insights and innovative

solutions to health problems …”Everything Likely to Win Some Resources!!”

NALBOH leadership: finding NALBOH leadership: finding the core in “CORE the core in “CORE COMPETENCY”??COMPETENCY”??

THE EIGHT Core THE EIGHT Core CompetenciesCompetencies

(Council on Linkages building (Council on Linkages building on 1988)on 1988)

Analytic/Assessment Skills Policy Development/program planning Communication Cultural Competency Community Dimensions of Practice Basic Public Health Sciences Financial Planning and Management Leadership and Systems Thinking


and CERTIFICATIONand CERTIFICATIONWhat are the credentials needed to work in

the public health system?How can these be tied to competencies?How should we go about documenting

competency to practice?If “certification”, how should we certify,

and whom, and for what?


and CERTIFICATIONand CERTIFICATION What are the credentials needed to work in the

public health system? How can these be tied to competencies? How should we go about documenting

competency to practice? If “certification”, how should we certify, and

whom, and for what? What challenges lie ahead for the “American

Board of Public Health”?


and CERTIFICATIONand CERTIFICATION

AND MOST IMPORTANT: HOW CAN WE DO ALL OF THIS WHILE ADDRESSING THE CRITICAL WORKFORCE SHORTAGE FOR PUBLIC HEALTH IN THE DECADE AHEAD??

NALBOH in the leadership: NALBOH in the leadership: using the “system using the “system

performance standards”performance standards”

The National PH Performance The National PH Performance Standards Program(NPHPSP) Standards Program(NPHPSP) building directly on the Model building directly on the Model Standards in the 1988 reportStandards in the 1988 report

THREE “instruments” OMB approved with

‘control numbers’ STATE LOCAL GOVERNANCE

Four Concepts Applied in Four Concepts Applied in NPHPSPNPHPSP

1. Based on the ten Essential Public Health Services

2. Focus on the overall public health system

3. Describe an optimal level of performance

4. Support a process of quality improvement

The local public health system The local public health system assessment instrumentassessment instrument

OMB Control Number 0920-0555

24 hours per response “…ALL entities that

contribute to the delivery …”


“How much of this Model Standard is achieved by the local PHS collectively?”

What percent of the answer reported in Q 1 is the direct contribution of the local PH agency?


For the LPHS … asks about GOVERNANCE

For the GOVERNANCE instrument, critical issues to NALBOH include …

Mobilizing for ActionMobilizing for Action through through

Planning and Partnerships (MAPP)Planning and Partnerships (MAPP)

Developed by NACCHO and CDCBased on the 1988 recommendations,

development began in 1996, released in 2001Community strategic planning toolWeb-based tool – www.naccho.org

NPHPSP and MAPPNPHPSP and MAPPNPHPSP Local

Instrument used within MAPP to assess public health system capacity

MAPP provides the process for addressing weaknesses and building on strengths

NACCHO Operational NACCHO Operational Definition of a Definition of a

Functional Local Health Functional Local Health DepartmentDepartment

Co-funded by CDC and RWJFGoal: Shared understanding of what people

can reasonably expect from LHDsBuilds on the “AGPALL” 1988 Framed around the ten Essential Services but

presented in more common languageAccommodates variety in LHD structure and

governance

““Public health is a complex Public health is a complex concept, but the operational concept, but the operational definition can help dispel the definition can help dispel the

mystery. Eventually public health mystery. Eventually public health can be recognized and valued can be recognized and valued

even wheneven when——particularlyparticularly when when——things are going well.things are going well.””

Susan GerardDirector, Arizona Department of Health Services

Public health is a complex Public health is a complex concept and so we need to concept and so we need to

develop a meaningful identifiable develop a meaningful identifiable BRAND BRAND

IOM Reports 1988/2003 – IOM Reports 1988/2003 – National Catalyst for National Catalyst for

AccreditationAccreditation Establish a “national commission to explore accreditation”

Further states…– “This (accreditation)

commission should focus on the development of a system that will further the efforts of NPHPSP.”

Building on the 1988 Building on the 1988 recommendations: recommendations:

Exploring AccreditationExploring Accreditation Co-funded by CDC and RWJF Jointly led by NACCHO, ASTHO,

NALBOH and APHA Informed by the Multi-State Learning

Collaborative Model addressed governance, standards,

financing and incentives, and evaluation Model for voluntary accreditation

developed and approved Accreditation for state Accreditation for state

and local health and local health departments is both departments is both

desirable and feasible!desirable and feasible!

THE TEN Essential Services THE TEN Essential Services (cont)(cont)

Enforce laws and regulations … Link people to needed personal health svcs.. Assure a Competent public health AND personal

health care workforce Evaluate effectiveness, accessibility and quality of

personal and population based Services Research for new insights and innovative

solutions to health problems Oh, yes … and number ELEVEN: Governance

and management of heath department resources

Public health system Public health system assessment instruments and assessment instruments and

A CCREDITATIONA CCREDITATION Can achievement of a

“passing grade” on a performance assessment be used for accreditation?

How should WHO accredit WHOM and HOW? (not to mention WHY?)


ACCREDITATIONACCREDITATION Can achievement of a

“passing grade” on a performance assessment be used for accreditation?

How should WHO accredit WHOM and HOW? (not to mention WHY?)

SEE: “Exploring Accreditation” and CDC’s NPHPSP website


ACCREDITATIONACCREDITATION AND MOST

IMPORTANT, HOW CAN WE KEEP ON TOP OF THE SPECIFIC HEALTH CHALLENGES WHILE WE TEND TO THE INFRASTRUCTURE??

LEADERSHIP Questions for LEADERSHIP Questions for NALBOH:NALBOH:

How can Essential Services, How can Essential Services, Competencies, and Competencies, and

Performance Standards Performance Standards inform accreditation and inform accreditation and

certification? certification? Especially NOW!!Especially NOW!!

Essential Services=Essential, Essential Services=Essential, Competencies=Unique and Competencies=Unique and

necessary, and Performance necessary, and Performance Standards and a new Standards and a new formulation can inform formulation can inform

advocacy for public health!advocacy for public health!Especially NOW!!Especially NOW!!

Sometimes the best way Sometimes the best way to lead progress is to take to lead progress is to take

a moment to look backa moment to look back

SO … let’s celebrate twenty years of “the

future”

IOM’s LANDMARK REPORT ON IOM’s LANDMARK REPORT ON “THE FUTURE OF PUBLIC “THE FUTURE OF PUBLIC

HEALTH” 1988HEALTH” 1988

… and FIVE years into Assuring the Health of the Public in the 21st Century



THE FUTURE OF

THE PUBLIC’S

HEALTH

in the 21st Century

The best way to predict the The best way to predict the future is to CREATE it. (P future is to CREATE it. (P

Drucker)Drucker)

SO .. LET’S TALK… NALBOH’s leadership

counts!!!

THANKS!

BACKUP SLIDES FOLLOW

The Public Health System: The Public Health System: What We Don’t Know but What We Don’t Know but

YOU can help us to find out!!YOU can help us to find out!! RESEARCH … the tenth “essential service” … ie

not someone else’s job Public Health Systems Research … much in need

of help but enormous progress (Council on Linkages!)

FAILURE to collect the evidence base precludes evidence-based policy

(witness the IOM report)

The Public Health System: The Public Health System: What We Don’t Know but What We Don’t Know but

YOU can help us to find out!!YOU can help us to find out!! What is the optimal allocation of responsibilities

among partners? What is the appropriate funding formula for the

system? What is the minimal staffing for a competent local

official health agency? What is the minimum size below which an

efficient/effective infrastructure is not possible?

The Public Health System: The Public Health System: What We Don’t KnowWhat We Don’t Know

What is the largest population to be served and still be ‘local’?

What is the optimal mix of disciplines or competencies in the competent agency?

How far is too far away for a local agency?What is the appropriate or optimal

relationship between the State Health Agency and the local official agency(ies)?

The Public Health System: The Public Health System: What We Don’t Know but What We Don’t Know but YOU need to help with!YOU need to help with!

What do we know about governance and what do we need to know? How does this differ across the “five … or is it more? … Americas”

What is the evidence for best performance from a Local Agency or Board of Health?

How many jurisdictions can a local agency manage or a board of health “govern”?

How can public health most effectively relate to local general purpose government?

Ahead of the pace … “Who will Ahead of the pace … “Who will Keep the Public Healthy?”Keep the Public Healthy?”

The PIPELINE is dangerously empty and the audience is dangerously “graying”

SO: we needed to assess the past and current state of training and education for public health professionals and develop recommendations for strengthening public health education

Companion StudyCompanion Study“Who will keep the Public “Who will keep the Public

Healthy?”Healthy?”

Utilize recommendations and other information from the Assuring the Health report

Ten-year look forward

Companion StudyCompanion Study“Who will keep the Public “Who will keep the Public

Healthy?Healthy?

Kristine Gebbie Mark CullenLinda Rosenstock Bob GoodmanSusan Allan Alan

GuttmacherKaye Bender Rita KukafkaDan Blazer Sheila SmytheScott Burris Roxanne Parrott

Companion StudyCompanion Study“Educating Public Health “Educating Public Health Professionals for the 21Professionals for the 21stst

Century”Century”

Process and development of recommendations similar to “Future of the Public’s Health” study

Final Report issued on November 4 and ‘launched’ at APHA in the late fall 2002!

Companion StudyCompanion Study“Educating Public Health “Educating Public Health Professionals for the 21Professionals for the 21stst

Century”Century”

A MODEL of health that emphasizes the linkages and relationships among multiple factors (or determinants) affecting health is an ECOLOGICAL MODEL”

““Educating Public Health Educating Public Health Professionals for the 21Professionals for the 21stst

Century”Century”KEY RecommendationsKEY Recommendations

SIX major responsibilities: Educate the leaders; focal point for Transdisciplinary Research; contribute to policy; collaborate with other schools for public health content; life-long learning; engage actively with various communities to improve the public’s health

““Who will Keep the Public Who will Keep the Public Healthy?” Keep the basics; Healthy?” Keep the basics; ADD Eight new competenciesADD Eight new competencies

Epidemiology, Statistics, Health Policy, Environmental Health, Social and Behavioral Sciences

Informatics, genomics, communication, cultural competence, community based participatory research , global health, policy and law and public health ethics

““Educating Public Health Educating Public Health Professionals for the 21Professionals for the 21stst

Century”Century”KEY RecommendationsKEY Recommendations

Primary Educational Mission: the preparation of individuals for positions of senior responsibility

Emphasize the centrality of the ECOLOGIC Approach

NEW competencies in genomics, communications, leadership, policy, law and ethics

““Who will Keep the Public Who will Keep the Public Healthy?” For EACH of the Eight Healthy?” For EACH of the Eight

new content areasnew content areas

Competencies be identified;Each area be included in graduate level

public health education;Continuing development and creation of

new knowledge be pursued; andOpportunity for specialization be offered.

NALBOH … a ‘closing keynote’ … NALBOH … a ‘closing keynote’ … a new time of oppor-TUNE-ity a new time of oppor-TUNE-ity

G-minor: Gee, there are certainly some minor problems (ahem!!) getting there

B-flat: Be flat-out proud of what our field and this state have already accomplished

B-sharp: There are wonderful opportunities ahead, but it will take a trained eye to see them in the current context

C-major!!

The best way to keep pace The best way to keep pace with progress is to be with progress is to be

ahead of it!!ahead of it!!

SO .. LET’S TALK… YOUR leadership

counts!!!

After all, Public Health is a After all, Public Health is a work in progress...work in progress...

I want to hear from YOU

NOW … and [email protected]

CELEBRATING TWENTY YEARS IN “The Future of Public Health” OPPORTUNITIES FOR TOMORROW’S...

Documents

Transcript of CELEBRATING TWENTY YEARS IN “The Future of Public Health” OPPORTUNITIES FOR TOMORROW’S...