State turns to public health program to help prepare for bioterrorism threats, to address other hazards that endanger Hoosiers

By Rich Schneider

Through its Master of Public Health (M.P.H.) Program, the department offers courses in disease control, environmental health and preparedness. The department's public health training center is already guiding local, county and state public health professi onals in such matters as, "Disaster Preparedness: Are You Ready?"

Recent support for the ramped up focus on public health comes from millions of federal dollars allocated to Indiana. A portion of these funds are targeted for education and training of public health professionals at the local and state levels.

While bioterrorism is a heightened threat, public health is used to combat hazards that endanger people, said Dr. Stephen Jay, chair of the Department of Public Health. Public health professionals work to prevent epidemics and the spread of disease, provi de immediate response when unusual symptoms or diseases are detected, protect against environmental hazards, promote safety and prevent injury, encourage healthy behaviors, promote sound public policies and respond to disasters by assisting communities in recovery.

The latest threat, however, does stretch even further public health's already limited resources.

"Prior to Sept.11, 2001, state and public health leadership had recognized the deficiencies in the public health workforce and constructive steps had been taken to begin to address these problems," Jay said. "The events of Sept. 11 have brought the weakne sses in public health infrastructure into stark focus. New federal resources have been allocated to states, including Indiana, to address preparedness needs. It is clear that the rate at which the deficiencies of public health infrastructure are addressed must be accelerated."

One early step taken to address public health deficiencies in Indiana was to establish the public health program at IUPUI, Jay said. In 1994, IUPUI Chancellor Gerald Bepko established a committee to assess the need for a graduate program in public health. In 1997, the Indiana Commission on Higher Education approved the three-year, part-time public health program that enables working professionals to get an M.P.H. degree by attending classes in the evening two nights a week. The first 33 students enrolled in the program in 1998.

The program was fully accredited by the Council on Education for Public Health in June, joining 45 other accredited graduate public health programs in the United States.

"This program is the most important building block in improving the states public health infrastructure since our public health workforce is only one-third the size of the national average," said Indiana State Health Commissioner Gregory Wilson. The U.S. average is 138 public health professionals per 100,000 population; Midwest average is 76 public health professionals per 100,000 population; and Indiana's average is 46 public health professionals per 100,000 population, he noted. Little appreciated and p oorly funded in comparison to other states, public health in Indiana has languished for years. It should come as no surprise, Jay said, that Indiana has among the highest rates of preventable diseases in the country. Indiana exceeds the national average i n the rate of deaths from stroke, heart disease and cancer per 1,000 population. It exceeds the national average in rates of obesity, poor mental health and teen pregnancies as well.

Jay points to compelling statistics that show that in the last decade obesity, consumption of alcohol and tobacco use by Hoosiers have increased. In recent years Indiana has witnessed some of the largest outbreaks of venereal diseases in the U.S. In addit ion, Hoosiers don't buckle up as often as people in many other states when they get behind the wheel. Unless improvements are made, Indiana will be unable to meet many of the national health objectives set out in the consensus guidelines, Healthy People 2 010.

The results of these kinds of unhealthy behaviors show up in a number of places, including the bottom line. Providing health insurance for Hoosier workers can cost businesses thousands of dollars more than their competitors in other states where the overa ll health of the population is better. Improving the health of the citizens of Indiana will be a major driving force for economic development in Indiana, Jay said.

According to Jay, former U.S. Surgeon General C. Everett Koop summed it up best when Koop said, "Health care is vital to all of us some of the time, but public health is vital to all of us all of the time."