Steven A. Schroeder

Health of the public

Academic medicine has contributed to the successes of the U.S. health care system, including excellence in biomedical research, extensive dissemination and use of medical technologies, lowered death rates for heart disease and stroke, and decreased rates of cigarette smoking. However, its substantial degree of public support and its central social role mandate that it become more involved in improving the health of the public. Relevant problems include poor health status and disproportionately high expenditures for medical care, inappropriate mix and distribution of medical manpower, and insufficient attention to chronic illness and disability. To help address these problems, Health of the Public, funded jointly by the Pew Charitable Trusts and the Rockefeller Foundation, has established programs in six academic health centers: Columbia; Johns Hopkins; Tufts; and the Universities of New Mexico, North Carolina, and Washington. These programs support population-based education for medical students and residents, research and training in clinical prevention, and reorientation of senior faculty members toward population-based concepts.

The Importance of Relating Medicine and Public Health

The historical division between medicine and public health is arbitrary and not in the best interest of the health of the American public. Combating the major causes of death and disability requires integration of medicine and public health by government and academia.