National Public Health Week

This week, April 5 to 11, is National Public Health Week (NPHW). The American Public Health Association sponsors National Public Health week across the country. Events are held locally in towns, cities, at health centers, and at Universities including our own. Each year there is a theme for National Public Health Week; this year's theme is eliminating health disparities. I am writing this viewpoint as a student of community health at Tufts, a future masters in public health student at Tufts Medical, and the coordinator of NPHW on the undergraduate campus.

I have found that when I tell friends and family about my plans to study and work in public health, they tend to be unsure what that means. After I tell them that I want to be an infectious diseases epidemiologist and would rather not work for the Centers for Disease Control and Prevention (CDC), they are really baffled! In honor of NPHW I would like to take a few minutes to explain what public health is, how it differs from medicine, and then discuss this year's theme of eliminating pubic health disparities.

Public health is an interdisciplinary field that focuses on maintaining the health of populations. Public health workers include nurses, doctors, dentists, veterinarians, social workers, mental health counselors, nutritionists, case managers, support group leaders, administrators, policy advocates, lawyers, and more. Epidemiologists, a subset of public health workers, track disease etiology and spread such as SARS. Environmental health workers ensure that your drinking water is safe. Public health veterinarians work on potential mad cow outbreaks. Public health educators teach of hand washing, safer sex, and the importance of immunizations.

Public health can be controversial: offering free clean needles to injection drug users, addressing sexual behaviors that are out of the norm for some people, and encouraging immunizations despite the rare study linking the MMR vaccine to autism. Other aspects of public health are less than glamorous, but nonetheless essential: monitory influenza patterns, ensuring food safety, and advocating for more government support for healthcare for all.

Though many doctors work in public health settings, medicine and the biomedical model are inherently different from public health. The biomedical model focuses on the health of the individual. Doctors concern themselves with the health of individual patients, ensuring the best care for that patient. Public health is concerned with the health of the community. This includes physical health aspects that medicine works with, as well as broader issues of mental health, nutrition, safe housing, education, and prevention services. Due to insurance systems and the expense of treatment, medicine is sometimes limited to helping patients who can afford services. Public health clinics and workers aim to help everyone, and often serve the poor and marginalized groups.

The story told ad nauseam in introductory public health classes to differentiate public health approaches from biomedical approaches involves babies and a river. As the story goes, (and I admit I am taking some poetic license to make it more interesting) a medical doctor and a public health worker are walking next to a river. As they are walking along, they see a baby floating downstream. They jump in and bring the baby out. The doctor lays the infant on the grass and is beginning to check her vital statistics when another baby floats down the river. And then a third. And a fourth. The doctor is frantically trying grab and treat each infant. Meanwhile, the public health worker has walked upstream to find out who is throwing babies in the river. This tall tale illustrates the focus on preventive care and population-based approaches that characterize public health.

A viewpoint of this length cannot begin to do justice to the atrocities in health disparities in this country. Instead, I would like to give you a few statistics, and urge you to visit our table in the campus center this week for more information (the table will be set up at lunchtime Monday-Friday).

w Vietnamese women are almost five times as likely to have cervical cancer as white women.

w African-American men die from cancer 50 percent more than white men.

w Hispanics and Mexican-Americans are almost twice as likely as whites to get type 2 diabetes. Native Hawaiians are 2.5 times as likely.

w Mexican-Americans are most likely to be exposed to pesticides; African-Americans to dioxins, PCP, and lead; white Americans to hydrocarbons.

w Men are 4 times more likely to die from firearm-related injuries than women.

w Women pay 68 percent more out of pocket for health services than men; mostly for reproductive health care.

w People with poor literacy are more likely to have a chronic disease and less likely to get the health care they need.

w Adults with poor health literacy have, on average, three times as many prescriptions filled as those with higher literacy.

w African-Americans are eight times more likely to die from AIDS than whites.

w African-American and Native American babies are less likely to live to their first birthday than white babies.

w Alaskan Native women, aged 20-44, are 16 times more likely to be hospitalized for assault.

w Heart disease, cancer, and diabetes rates are higher in rural areas.

w Death from heart disease occurs 29 percent more in African-Americans than whites and 49 percent more in men than women.



These statistics will be addressed in Barnum 114 on Wednesday at 6:30 pm. The film "The Angry Heart" will be shown and followed by a discussion with a leading African-American physician who participated in the film. (All statistics from APHA, 2004).

Eliminating the above health disparities is a gargantuan task that will take decades to accomplish. By raising awareness of these issues on campus, I hope that we are moving in the right direction. I encourage anyone with further questions to visit the table or contact me at rachel.jervis@tufts.edu.

Rachel Jervis is a senior majoring in Biology and Community Health.