Public health program focuses on prevention

OB/GYN News, Dec 1, 2002 by Steve Perlstein

As he surveyed the growing public health crisis tearing through the Baltimore community around him and considered that a mere 2% of the billions of dollars in annual public health funds in the United States go to prevention of problems such as addiction and violence, Jay Carrington Chunn, Ph.D., decided it was time to act.

Those factors were the impetus for Dr. Chunn, associate vice president for academic affairs at Morgan State University, Baltimore, to put in place what he calls the nation's first public health doctorate program focused on prevention rather than on research. That approach was validated in July when the WK. Kellogg Foundation awarded Morgan State and Dr. Chunn a $600,000, 3-year grant to form the National Center for Health Behavioral Change.

"Public health as a profession had become too research and policy focused," Dr. Chunn commented. "Not to negate research, which is important, but prevention of health problems has become a sideline to this profession."

When he began surveying 27 schools of public health across the country, Dr. Chunn said he found two things. First, only Morgan State was a predominantly African American institution. Second, none of the 27 schools focused on disease prevention, steering instead toward academic research, he said.

"It only stood to reason that we should develop a program at the doctoral level," Dr. Chunn said.

The center, funded by the Kellogg grant, through a group of senior fellows, aims to work toward disseminating prevention in the public health community through these six steps:

* Develop health behavioral change curricula for schools of public health, psychiatry, and psychology.

* Identify pressing research needs in the area of health behavioral change.

* Develop cross-cultural training materials for public health practitioners in the field.

* Provide technical assistance to schools of public health in integrating cultural competency into their curricula.

* Assemble a top group of professionals across several disciplines to develop health behavior change theory and to validate that theory through practice.

* Foster community-based public health practice with an emphasis on breaking new ground in prevention methods.

"We had serious health problems in the community, and it became really apparent to me that we needed a prevention program in public health," Dr. Chunn commented.

The decades-long process of conducting, validating, and disseminating research is making the field of public health irrelevant, and steps such as those Dr. Chunn are taking are critical, especially at a time of significant public health crisis such as this, said Dr. Carl C. Bell, president and CEO of the Community Mental Health Council and director of public and community psychiatry at the University of Illinois at Chicago. Dr. Bell is one of the senior fellows of Dr. Chunn's center.

"This is a conversation people have been waiting to hear for some time," Dr. Bell said. "Somebody somewhere along the line had to break the box and say, 'This is crazy,' because we've got to do something very different considering the health problems we are having in this country."

Indeed, it was those critical public health issues he saw every day in Baltimore that spurred Dr. Chunn to action.

"Baltimore was leading the country in syphilis rates [and] HIV/AIDS was on the rise. We have serious drug problems here, serious violence problems, and a high homicide rate," he said. "It was obvious to me we needed to redirect our efforts."

The first full class for the new programs--a 4-year doctorate degree and a 2-year master's degree--was admitted in 1999. Since then, Dr. Chunn said, the response has been "astronomically high," with as many as 100 applicants per year vying for up to 30 spots.

One of the keys to the program is the internship component, where students spend time in Maryland's urban areas working with disadvantaged communities as a means of putting their education into practice, Dr. Chunn said.

"We can't yet claim significant progress that's moved mountains, but we know our students are making a difference," he said.