of implementing recommendations to significantly enhance federal funding for both public health education and leadership development and for public health research overall, including research on population health, public health systems, and public health policy. Investment in public health education is inadequate. Federal support for non-physician graduate public health training is minimal, and funding for residencies in preventive medicine is only about $1 million (Glass, 2000).

Therefore, the committee recommends that federal agencies provide increased funding to

  • develop competencies and curriculum in emerging areas of practice;

  • fund degree-oriented public health fellowship programs;

  • provide incentives for developing academic/practice partnerships;

  • support increased participation of public health professionals in the education and training activities of schools and programs of public health; especially, but not solely, practitioners from local and state public health agencies; and

  • improve practice experiences for public health students through support for increased numbers and types of agencies and organizations that would serve as sites for practice rotations.*

In terms of research funding, comparatively few resources have been devoted to supporting prevention research, community-based research, transdisciplinary research, or the translation of research findings into practice. Current funding for research is focused almost entirely on two components of the ecological model of health—biologic determinants and medical cures. According to Scrimshaw and colleagues (2001), only 1 to 2 percent of the U.S. health care budget is spent on prevention and a like imbalance exists between funding for basic biomedical research and population-based prevention research. Analysis shows that at least 50 percent of mortality is due to factors other than biology or medical care (McGinnis and Foege, 1993).

Although it is not realistic at this time to propose a shift in funding for public health research to levels commensurate with the burden of need, the committee believes that significant steps in this direction are now amply justified and warranted. Accordingly, the committee recommends that

  • there be a significant increase in public health research support

*  

Dr. Alan Guttmacher, because of his position as a federal employee, did not participate in discussions nor take a position regarding committee recommendations pertaining to federal funding.



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