Prevention has long played second fiddle to treatment in the world of medicine, according to Edward Ellerbeck, MD, MPH, professor and chair of the Department of Preventive Medicine and Public Health at KU Medical Center. But with a newfound emphasis on halting problems before they start, policymakers are starting to view public health in a new light.

“The public health movement favors a dynamic approach to health care, bringing together physicians, patients, researchers, the community, and insurance providers to reduce costs and prevent health problems before they begin,” Dr. Ellerbeck said.

Such efforts have already begun across Kansas. In addition to encouraging better physical fitness and healthier eating, employers and insurance providers are seeking to nudge clients toward a healthier lifestyle by offering insurance discounts to workers who, for example, don’t smoke or pledge not to use tobacco.

KU Medical Center hopes to be at the forefront of this public health movement by opening a new School of Public Health, which would serve as the primary resource center for statewide policies and procedures on public health matters.

A truly beneficial and efficient public health system links policymakers, academia, health care providers, and citizens. The new School of Public Health, which is still a decade away from becoming a reality, could serve as a link among those existing health care and education structures.

The need for such a school in Kansas is urgent. “A quarter of the existing workforce in public health will retire in the next five to 10 years,” said Glen Cox, MD, MBA, MHSA, professor and chair of the Department of Health Policy and Management and director of the new Institute of Community and Public Health. “Our current training programs are insufficient to replace those who are retiring. We have to create curricula to help prepare people to develop a workforce in public health.”

The nuts and bolts of establishing a new School of Public Health require diversifying existing education programs and creating new ones, Dr. Cox said. Work is currently underway on linking existing health care and education structures, securing additional funding, and meeting accreditation requirements.

The new school would offer Master’s degrees in five programs, as well as three doctoral programs. The latter would afford significant research collaboration between the Medical Center campuses in Kansas City and Wichita and the Lawrence campus.

“A new school would help create an infrastructure for public health,” Dr. Cox said. “We’ve had successful communitybased research, but we don’t have that robust connection with governmental organizations yet. The state is not currently in a position to get as much federal funding in research and service delivery, but that would change with the development of a public health infrastructure.”

The proposed School of Public Health will provide a three-pronged approach to tackling health problems in Kansas: service in public health, with researchers studying policies and procedures; education in public health, with training of health professionals who have an understanding of a population-based approach to health; and research in public health, in which experts could study better means of health care delivery and of insuring citizens.

Such an approach would mean combining and utilizing a diversity of resources from universities, state government, and the private sector. Proponents of the school say that it would be a clearinghouse of information and research for organizations all over the state.

For example, when writing new state laws regarding health care, legislators could refer to the School’s research on the best ways to develop health-friendly cities and encourage healthy behavior. Similarly, insurance providers could use the school’s findings to develop an incentive-based public health approach to insurance.

The new School of Public Health would also provide a designated face for the Medical Center’s diverse public outreach efforts, said Mary Beth Warren, RN, MS, statewide director of the KU Area Health Education Centers, which offer programs, continuing education and services to medical, nursing and allied health students as well as to rural providers in the state.

“We’re trying to enhance the quality and accessibility of health care in every part of Kansas, and a School of Public Health would greatly aid our efforts,” Warren said.

The movement to create a new School of Public Health is not strictly a KU-centered effort. Douglas Bradham, DrPH, chair of Preventive Medicine and Public Health at the KU School of Medicine in Wichita, says that the new school would serve as a catalyzing agent for a much larger statewide effort.

“The vision for this school is that we have an opportunity to embrace partnerships between the public and private sectors, in the same way the medical school in Wichita joins the private and public,” he said. “We have a lot of talent at universities across the state, in the business community, and in state government.”

One of the challenges facing predominantly rural states like Kansas, Dr. Bradham said, is the absence of connected metropolitan networks that breed closer public health collaboration.

“Rural states need a new framework,” Dr. Bradham said. “We’re talking about a truly all-encompassing view of public health and cooperation, one that involves all campuses and health organizations in the state.”

The financial and organizational challenges may be imposing, but the potential long-term benefits for the health of Kansans greatly outweigh the costs. When such a goal is accomplished, it will mean the dawn of a new age for the health of Kansas. +