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The Future of the Public’s Health in the 21st Century
health workforce. According to Gebbie (1999), the primary barrier to workforce development is the “incredibly weak” budget allocated for training. This has not always been the case, however. Over the past five decades, the major sources of funds for the training of students in public health were HRSA and CDC. Table 8–1 provides a chronology of legislation authorizing funds for health professional training in public health between 1956 and 1976 (DHHS, 1980).
In 1976, Congress passed the Health Professions Educational Assistance Act (P.L. 94–484). This act provided for a number of programs in health professions education, including
Extensions of existing public health traineeships.
Grants to accredited schools of public health for student traineeships.
A separate program of grants to public or nonprofit private educational entities (excluding schools of public health) that offered an accredited program in health administration, hospital administration, or health policy analysis and planning.
Funding to public or nonprofit private educational entities (excluding schools of public health) for graduate programs in health administration.
Grants to assist accredited schools of public health and other public or nonprofit educational entities with accredited graduate programs in health administration, health planning, or health policy analysis and planning in meeting costs of special projects to develop new programs or expand existing ones in the same four public health disciplines mentioned above.
A requirement for the Secretary of Health and Human Services, in coordination with the National Center for Health Statistics, to continuously develop and disseminate statistics and other information on the supply of and need for different types of public and community health personnel.
Between 1980 and 1987, spending by the Bureau of Health Professions (which is part of HRSA in the Department of Health and Human Services [DHHS]) for education in all health professions declined yearly, from a high of $411,469,000 in 1980 to $189,353,000 in 1987. General-purpose traineeship grants to schools of public health went from $6,842,000 in 1980 to $2,958,000 in 1987. Curriculum development grants, funded at $7,456,000 in 1980, were not funded at all in 1981 and 1982; but the funding recovered slowly in 1983, with funding at $1,740,000, and increased in 1984 to $2,856,000 and reached $9,787,000 in 1987. Grants for graduate programs in health administration were