Hoping to boost California's capacity to meet the health needs of the state's fast-growing and increasingly diverse population, the University of California, Davis, is exploring whether to establish a school of public health.

The new school would parlay the campus's location in California's agricultural heartland, its proximity to the state capital and its existing academic strengths to focus on rural and environmental health issues, as well as disparities in health care for various groups and communities.

In contrast to medicine, the field of public health focuses on disease prevention and the well-being of a population as a whole, rather than on the health needs of an individual.

"The expertise in our public health sciences program, and our long-recognized strengths in agriculture and the environmental sciences, offer the potential for developing a powerhouse public health program here at UC Davis," said Virginia Hinshaw, provost and executive vice chancellor.

Hinshaw noted that the campus currently has top-ranked talent in areas that are critically important to public health, including occupational and environmental health, rural and immigrant health, health disparities, reproductive health, nutrition and cancer.

"The teaching that complements these research efforts will benefit the next generation of public health specialists, as well as local, state and global health agencies," said Marc Schenker, professor and chair of the School of Medicine's Department of Public Health Sciences, who is co-chairing a multidisciplinary planning committee that is guiding the exploratory effort.

The committee, which includes UC Davis faculty members, public health professionals and community representatives, will submit a report in September addressing whether there is sufficient need for a school of public health at UC Davis and, if so, describing both the vision and scope of a school.

At the same time, UC Davis is conducting an assessment, funded by The California Endowment, aimed at gauging the need for training necessary to support California's public health workforce.

Currently, there are 37 accredited schools of public health in the United States, including four in California: UC Berkeley, UCLA, San Diego State University and Loma Linda University.

The role of public health

The challenges of public health continue to grow. In the United States today, for example, an estimated 435,000 deaths each year are related to tobacco use, another 400,000 annual deaths are related to diet and inactivity, and an estimated 85,000 annual deaths are linked to alcohol abuse.

"While California has made tremendous strides in addressing these health issues, particularly in preventing tobacco use, there is a glaring need in the state and nationwide for more highly trained public health professionals," Schenker said. "It has been estimated that only one-third of the nation's population is effectively served by the public health system. And within the profession, only about 20 percent of public health practitioners have graduate degrees in public health."

Bette Hinton, director of the Yolo County Health Department and a member of the school of public health planning committee, noted that a public health school at UC Davis would be an asset for the region.

"Many health professionals in Northern California are eager to earn a master's degree in public health, but can't take time from their jobs to pursue an advanced degree," Hinton said.

Growing need

There are an estimated 450,000 public health workers nationwide, 45 percent of whom serve in governmental positions. Surveys suggest that the greatest demand among public health occupations is for public health nurses, followed by environmental scientists, health educators, epidemiologists and administrators. One study found that recruitment of public health professionals has been challenging, in part, because of a limited pool of trained applicants. Rural communities appear to be hardest hit by the scarcity of public health professionals.

The problem is particularly acute in California, where an estimated 4 million residents already live in areas that are underserved by health care professionals. Statistics suggest that the need will only worsen. By 2015, it is projected that the state's population will have grown by 7.5 million, or 22 percent, since the figures were tallied in 2000. Meanwhile, enrollment in schools of public health is lagging far behind the population growth, due to limited class size in schools of public health.

"The challenge is exacerbated by the aging of both the population, in general, and of the public health workforce," Schenker said, noting that California has the largest elderly population in the nation. "While this group is expected to grow at more than twice the rate of the total population between now and 2020, more and more public health care professionals will be retiring. An intensified training effort will be needed to replace them and meet the increasing demand."

And as it grows, California's population is becoming more ethnically diverse. Demographic projections indicate that Hispanic Americans will be the largest ethnic group in California by 2025, increasing the need for an ethnically diverse public health workforce.

Envisioning a school of public health

The public health school envisioned for UC Davis would focus on training public health professionals, improving information and data systems needed for surveillance and analysis, and assisting state and local health departments.

The school would integrate expertise from a variety of disciplines across campus, ranging from medicine, veterinary medicine and nutrition to economics and statistics. It would offer at least three doctoral programs, as well as master's degrees in the five core areas of public health: epidemiology, biostatistics, environmental health, health education and behavioral health, and health services management and policy.

UC Davis currently has a public health sciences department that is focused on improving health through educational programs, epidemiologic research, and public service and policy development. It specializes in health promotion and disease prevention, occupational and environmental health, health care delivery, gerontology, ethical issues, and reproductive, rural, minority and international health.

The campus offers a master's degree in public health (MPH) and graduate degrees in epidemiology, biostatistics, nutrition, pharmacology and toxicology, and other public health-related disciplines. In addition, the veterinary school has a 40-year-old master's degree program in preventive veterinary medicine (MPVM), as well as several programs that deal with global health and disease prevention.

"Veterinary medicine has long played a key role in public health, by protecting the well-being of food animals and tracking diseases that can spread from animals to humans," said Bennie Osburn, dean of the School of Veterinary Medicine. "A school of public health at UC Davis would fuse our many diverse academic strengths to train public health professionals and provide the research needed to tackle the pressing health problems that face California and the nation."

The school also would have opportunities to collaborate with colleagues at the nearby California Department of Health Services, the largest and preeminent state health department in the nation, as well as local health departments.