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Who Will Keep the Public Healthy? Educating Public Health Professionals for the 21st Century (2003)
Board on Health Promotion and Disease Prevention (HPDP)
Institute of Medicine (IOM)

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. "Appendix D: Education of Public Health Professionals in the 21st Century." Who Will Keep the Public Healthy? Educating Public Health Professionals for the 21st Century. Washington, DC: The National Academies Press, 2003.

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Who Will Keep the Public Healthy?: Educating Public Health Professionals for the 21st Century

tials—but it claimed a certain moral authority in representing the most highly developed schools of public health.

THE POST-WAR YEARS: TOWARD ACCREDITATION

In 1946, the Committee on Professional Education of the American Public Health Association took over the job of monitoring the standards of public health education. William Shepard, then Third Vice-President of the Metropolitan Life Insurance Company, energetically chaired the committee. Shepard complained about profit-making public health training courses of dubious quality; at least one school was offering public health degrees by correspondence, its “faculty” consisting of several authors of leading texts on public health who were entirely unaware of their “appointment.”20 At least a dozen universities were in the process of establishing schools of public health, some of them with no new faculty— merely using existing faculty as part-time teachers. Proprietary schools, complained Shepard, constituted a “dark period” in the development of a profession—marking the moment when demand for trained people exceeded supply. Given the large demand for public health personnel and the relatively sparse supply, the APHA Committee saw its task in part as differentiating between good and poor candidates and as stemming the tide of poorly-trained “incompetents.”

The Committee on Professional Education also created a plan for the accreditation of schools of public health, financed in its earliest years by the Commonwealth Foundation. Thanks to studies by Haven Emerson and Martha Luginbuhl,21 the Association was able to estimate how many full-time public health personnel were needed in the nation, the replacement rate of existing public health officers, and therefore the number of schools of public health that were really needed—Shepard estimated in 1946 that between 5 and 10 additional schools of public health would be necessary to provide the public health workforce for the nation.

The difficulty with instituting a system of licensing and credentialing was the low salaries involved in most public health positions. With the war and the depression behind, public health positions were failing to attract the most highly-qualified candidates. Physicians, in particular, showed little enthusiasm for public health appointments. The attractions of private and hospital practice far outpaced the appeal of public health agencies. There seemed little point in attempting to impose any form of licensing when the number of jobs so outstripped the number of available candidates, and public health positions for the most part were regarded

20  

Shepard, “Professionalization,” p. 149.

21  

Haven Emerson and Martha Luginbuhl, Local Health Units for the Nation. New York: The Commonwealth Fund, 1945.

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