Career
Center Resources
Health Services Admininstration | Biostatistics
| Epidemiology | Behavioral
Science/Health Education | Environmental Health
Sciences |International/Global Health
| Biomedial & Laboratory Practice
| Nutrition | Public
Health Practice & Program Management | Maternal
& Child Health | Occupational Safety
& Health The mission of public health is to "fulfill society's interest
in assuring conditions in which people can be healthy." (Institute
of Medicine, Committee for the Study of the Future of Public Health,
Division of Health Care Services. 1988. The Future of Public Health.
National Academy Press, Washington, DC) • assessment and monitoring of the health of communities
and populations at risk to identify health problems and priorities; • formulating public policies, in collaboration with community
and government leaders, designed to solve identified local and
national health problems and priorities; • assuring that all populations have access to appropriate
and cost-effective care, including health promotion and disease
prevention services, and evaluation of the effectiveness of that
care. The Ten Essential Public Health Services* • Monitor health status to identify community health problems
Adopted: Fall 1994, Source: Public Health Functions
Steering Committee, Members (July 1995): American Public Health
Association, Association of Schools of Public Health, Association
of State and Territorial Health Officials, Environmental Council
of the States, National Association of County and City Health Officials,
National Association of State Alcohol and Drug Abuse Directors,
National Association of State Mental Health Program Directors, Public
Health Foundation, U.S. Public Health Service --Agency for Health
Care Policy and Research, Centers for Disease Control and Prevention,
Food and Drug Administration, Health Resources and Services Administration,
Indian Health Service, National Institutes of Health, Office of
the Assistant Secretary for Health Substance Abuse and Mental Health
Services Administration Core Areas of Public Health While there are dozens of specialties in public health, most career
opportunities are found within the following fields. How Is Public Health Different from Other Health Professions?
Health carries out its mission through organized, interdisciplinary
efforts that address the physical, mental, and environmental health
concerns of communities and populations at risk for disease and
injury. Its mission is achieved through the application of health
promotion and disease prevention technologies and interventions
designed to improve and enhance quality of life. There are many distinctions between public health and the clinical
health professions. While public health is comprised of many professional
disciplines such as medicine, dentistry, nursing, optometry, nutrition,
social work, environmental sciences, health education, health services
administration, and the behavioral sciences, its activities focus
on entire populations rather than on individual patients. For example, doctors treat individual patients one on one for a
specific disease or injury. Thus, patients need medical care only
part of the time — namely, when they are ill. Public health
professionals, on the other hand, monitor and diagnose the health
concerns of entire communities and promote healthy practices and
behaviors to assure our populations stay healthy. Thus, communities
need public health all of the time in order to stay healthy. For that example, this population-based approach to health: • assures that our drinking and recreational waters are
safe Core Areas of Study in Public Health Health Services Administration return to top of page Biostatistics can be defined as the development and application
of statistical and mathematical methods to the design and analysis
of public health problems, programs and biomedical research. Biostatistics
is the science that applies statistical theory and principals to
research in the fields of medicine, environmental science, biology,
public health and related fields. Biostatisticians use statistical
measures, as well as their other public health training to analyze
the effectiveness of new drugs, analyze risk factors, plan interventions
and explain biological phenomena. Students entering into a biostatistics program should possess a
broad knowledge of biology and a solid understanding of mathematics
and statistical methods and measures. Career opportunities for graduates
offer competitive salaries. Positions are available in data management,
pharmacuetical and clinical trials, data analysis and academia.
In addition, biostaticians are needed at the federal, state, and
local levels. Epidemiology Contributions of Epidemiology Suggested websites and readings for those who want to learn more
about what epidemiology is: • UCLA website devoted to the life and times of Dr.
John Snow (1813-1858), a legendary figure in the history of
epidemiology, public health and anesthesiology: http://www.ph.ucla.edu/epi/snow.html
• Ian R. H. Rockett, "Population and Health: An
Introduction to Epidemiology," Population Bulletin, Vol.
49, No. 3 (Washington, DC: Population Reference Bureau, Inc.,
November 1994). • Paul D. Stolley and Tamar Lasky, Investigating Disease
Patterns: The Science of Epidemiology, New York: Scientific
American Library, 1995. • M. Terris. "The Epidemiologic Tradition: The Wade
Hampton Frost Lecture," PH Reports, Vol. 94, No. 3 (1979):
203-209. • Anders Ahlbom and Staffan Norell, Introduction to Modern
Epidemiology, 2nd ed. Massachusetts: Epidemiology Resources,
Inc., 1990. • Charles H. Hennekens and Julie E. Buring, Epidemiology
in Medicine, Boston: Little, Brown and Company, 1987. • David E. Lilienfeld and Paul D. Stolley, Foundations
of Epidemiology, 3rd ed. New York: Oxford University Press,
1994. Behavioral Sciences/Health Education Environmental Health Sciences Environmental health sciences is a complex, multifaceted field
of protecting against environmental factors that may adversely impact
human health or the ecological balances essential to long-term human
health and environmental quality. Environmental health is an effort
engaged in by a varied assortment of disciplines and professions
within a broad array of organizations. At the federal level, such
agencies as the Environmental Protection Agency (EPA), the National
Center for Environmental Health (NCEH at CDC), the Agency for Toxic
Substances and Disease Registry (ATSDR) and the Food and Drug Administration
(FDA), are among those delivering important environmental health
and protection services. Environmental health is the largest component
of the public health field and accounts for approximately half of
its personnel and expenditures (Environmental Health, Gordon, 1998).
• air quality In addressing these areas, environmental health employs disciplines
such as epidemology, biostatistics, toxology, management, public
policy, risk assessment, communication, and environmental law. It
also calls on the expertise of other professionals such as chemists,
geologists, biologists, meterologists, physicists, physicians and
engineers. International/Global Health Biomedical & Laboratory Practice Nutrition Public Health Practice & Program Management Maternal and Child Health Occupational Safety & HealthWhat is Public Health?
Public health carries out its mission through organized, interdisciplinary
efforts that address the physical, mental and environmental health
concerns of communities and populations at risk for disease and
injury. Its mission is achieved through the application of health
promotion and disease prevention technologies and interventions
designed to improve and enhance quality of life. Health promotion
and disease prevention technologies encompass a broad array of functions
and expertise, including the three core public health functions:
• Diagnose and investigate health problems and health hazards
in the community
• Inform, educate, and empower people about health issues
• Mobilize community partnerships to identify and solve
health problems
• Develop policies and plans that support individual and
community health efforts
• Enforce laws and regulations that protect health and ensure
safety
• Link people to needed personal health services and assure
the provision of health care when otherwise unavailable
• Assure a competent public health and personal health care
workforce
• Evaluate effectiveness, accessibility, and quality of
personal and population-based health services
• Research for new insights and innovative solutions to
health problems
Regardless of their specialties, all students take introductory
courses in biostatistics and epidemiology, sciences basic to public
health. Most schools also require one or more courses in health
administration, environmental health and behavioral sciences. These
core areas are essential for a Master's in Public Health (MPH) and
recommended for all degree candidates. Once an area of concentration
has been chosen, a student and his or her advisor will develop a
course of study geared to the student's individual professional
goals, encompassing classroom activity, a supervised field experience,
and a significant research or laboratory project. Many schools either
require or strongly recommend some type of work experience before
enrollment and most encourage their students to seek summer employment
which will further develop and enrich their public health background.
• prevents pollution of our air and land through enforcement
of regulatory controls and management and disposal of hazardous
wastes
• eradicates life threatening diseases such as smallpox
and polio
• controls and prevents infectious diseases and outbreaks
such as measles, HIV/AIDS, tuberculosis, and the Ebola virus
• reduces death and disability clue to unintentional injuries
through the formulation of policies designed to protect the safety
of the public, such as seat belt and worker safety laws
• facilitates community empowerment to improve mental health,
reduce substance abuse and social violence
• promotes healthy lifestyles to prevent chronic diseases
such as cancer heart disease, and obesity
• educates populations at risk to reduce sexually transmitted
diseases, teen pregnancy, and infant mortality
• assures access to cost effective care
• evaluates the effectiveness of clinical and community-based
interventions
Persons seeking careers in administration or resource management
in the public or private sectors of health service delivery can
specialize in health planning, organization, policy formulation
and analysis, finance, economics or marketing.
According to the Institute of Medicine (IOM), Health Services Administration
is a multidiscplinary field of inquiry, both basic and applied,
that examines the use, costs, quality, accessibility, delivery,
organization, financing, and outcomes of health care services to
increase knowledge and understanding of the structure, processes,
and effects of health services for individuals and populations (IOM,
1995).
As health care delivery continues to evolve, professionals trained
in Health Services Administration are in high demand. Today's managed
care environment requires trained professionals to focus on the
study of health care systems, health care reform, health law, financial
management, clinical management, and policy analysis. In addition,
health administrators play an important role in the organization
and financing of medical care, analysis of utilization patterns,
patient and provider relations, developing health information systems,
monitoring changes in health service demand and delivery.
Students who graduate with training in health service administration
can find career opportunities in administration or resource development
in the public or private sectors of health service delivery and
can specialize in planning, organization, policy formation and analysis,
finance, economics, and marketing. Health service administrators
play a leadership role in regional, state, national, and international
agencies and organizations.
Biostatistics
Career opportunities in this area involve the application of statistical
procedures, techniques and methodology to characterize or investigate
health problems and programs.
Due to a nationwide shortage, opportunities abound for specialists
trained in the systematic study of the distribution and determinants
of disease or disability in population groups.
Epidemiology is the study of patterns of disease and injury in human
populations and the application of this study to the control of
health problems. Epidemiology may be viewed as based on two fundamental
assumptions: first, that human disease does not occur at random,
and second, that human disease has causal and preventive factors
that can be identified through systematic investigation of different
populations or subgroups of individuals within a population in different
places or at different times. As a fundamental science of preventive
medicine and public health, epidemiologic research has traditionally
focused on questions of disease causation through population studies
for both infectious and chronic diseases. Epidemiologic studies
focus on identifying distribution, determinants, and frequency of
disease within populations by using statistical analysis. Epidemiologists
develop and evaluate hypotheses about the effects on human health
of hereditary, behavioral, environmental, and health care factors,
and develop the knowledge basis for disease prevention and control
programs. The field is interdisciplinary and has a methodology distinctive
from, but also dependent on, biostatistics. Epidemiologists also
make extensive use of the contributions of biological, clinical,
and other sciences including techniques derived in biochemistry
and molecular biology.
The range of topics now addressed by epidemiologic methods includes
health promotion, disease prevention, and assessing the quality
of health care. Quantitative skills, including biostatistics and
computer applications are emphasized in all schools of public health
degree programs.
While basic research may add to the biologic understanding of why
an exposure causes or prevents disease, only epidemiology allows
the quantification of the magnitude of the exposure-disease relationship
in humans and offers the possibility of altering the risk through
intervention. Epidemiologic research has often provided information
that has formed the basis for public health decisions long before
the basic mechanism of a particular disease was understood.
For example, epidemiologic findings led to the judgement by the
U.S. Surgeon General in 1964 that there was proof beyond a reasonable
doubt that cigarette smoking caused lung cancer years before there
was any clear understanding of alterations in DNA by initiators
or promoters of cancer, let alone of the physiologic effects of
tobacco or its individual constituents.
Similiarly, the large increase in cases of toxic shock syndrome
among young women was attributed to the use of super absorbent tampons
through a number of epidemiologic observations. Based on this evidence,
but without an understanding of any biologic mechanism, such products
were removed from the market in 1980, with a resultant marked decrease
in the development of the disease. It would be another five years
before it was postulated that an interaction among super absorbent
tampon fibers, magnesium, and bacterial growth was the mechanism
responsible for development of this disease.
These specialists use specific methods, skills and program strategies
to help people choose healthier lifestyles, to make more efficient
use of health services, to adopt self-care practices and to participate
actively in the design and implementation of programs that affect
health.
There has been growing recognition that the social and behavioral
sciences play a critical role in public health academics and in
practice. The social and behavioral sciences of anthropology, psychology,
political science, sociology, and health education are nationally
recognized subspecialties in public health educational, research,
practice and training programs. All schools of public health offer
a core course to address the social and behavioral issues in public
health. Some examples of these concentrations include mental health,
aging, health promotion and disease prevention, public health practice,
health education and behavior change, disability and health, and
social research.
Environmental health includes many diverse disciplines such as chemistry,
toxicology and engineering, and is concerned with the identification,
and control of factors in the natural and man-made environment (air,
water, land, housing) which affect health.
Because environmental health is so broad in scope, it is often broken
down in academic and professional settings in areas of contact and
medians. These areas are:
• food protection
• radiation protection
• solid waste management
• hazardous waste management
• water quality
• noise control
• environmental control of recreational areas
• housing quality
• vector control
Other Public Health Fields
For persons seeking international careers, this field encompasses
virtually all specializations in public health and focuses on improving
health standards in developing countries.
This field encompasses a diverse array of specialists such as bacteriologists,
microbiologists and biochemists who use laboratory techniques for
the diagnosis and treatment of disease and for the investigation
of conditions which affect health status.
In short supply in the public and private sectors, these specialists
are concerned with the study of the interaction between nutrients,
nutrition and health and the application of sound nutritional principles
to maintain good health.
Specialization in this area encompasses many identifiable public
health programs and activities such as maternal and child health,
aging, mental health, environmental health and professional disciplines
such as medicine, dentistry, nursing, social work and other clinical
sciences.
This area focuses on the complex public health problems affecting
women, children, and their families, including discovering and testing
solutions through applied research at the local, state, national,
and international levels and participating in community activities
to improve the health of the MCH population.
Specialists employed in this field are concerned with the identification
of health and safety hazards related to work and the work environment,
as well as their prevention and control. FMI: go to the Association of Schools of Public Health (ASPH)
at www.asph.org
