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Grand Rounds on the Future of Public Health Linda Fried, MD, MPH, dean of the Mailman School of Public Health, hosts a new lecture series that aims to inspire innovative approaches to transform the public’s health – nationally and globally – setting our sights on leadership needs for the 21st century. To this end, the new Grand Rounds lecture series features leading figures in the field of public health in an effort to examine the current status of public health education, research and service, and reflect on what the future holds. Dr. Fried introduced the new series at the first lecture on September 3 by highlighting the significant advances achieved in the field of public health over the last century, while also pointing to current disparities in the U.S. system as a call to action. Noting the changing landscape of public health, including demographic shifts, an aging population, globalization, and climate change among others, Dr. Fried emphasized the critical role that academia can play when addressing these central trends and forces. In closing her remarks, Dr. Fried pointed to the significance of the occasion, stating, “This is a critical moment in history for public health, and a critical opportunity.” Upcoming Lectures November 11, 2008 December 3, 2008 December 8, 2008 Please visit www.mailman.hs.columbia.edu/grandrounds/index.html for a full schedule of speakers. Recap of Previous Lectures September 3, 2008 Drawing upon the social, political, economic, and ideological factors that shape the power of public health, Dr. Amy Fairchild discussed whether and how our history can inform the future of public health. Dr. Fairchild highlighted the forces that shaped public health in the 19th century, and those that framed its decline in the 20th century. To view the video, click here.
Dr. Boufford examined the role of academia in public health, and discussed how schools of public health can shape the future. Her talk addressed a variety of issues. Outlined in two key Institute of Medicine (IOM) reports from 1988 and 2002 – the 1988 report focused on the U.S. government’s role and assessing the nation’s public health infrastructure; and the 2002 report examined the role of public health and provided actionable recommendations for diverse communities. In addition, Dr. Boufford outlined contemporary issues examined by the IOM. She explained that public health funding is unbalanced, and, in recent years, there is a better understanding of the effects of key health determinants, such as behavior, environment, genetics, and access to medical care. To view the video, click here.
Dr. Fineberg suggested there are several challenges when it comes to promoting the benefits of a healthy public. First, the payback is not immediate but requires persistent behavior change rather than a quick fix. Second, a bias against errors of commission exists, with a tendency to accept avoidable harm as normal. Dr. Fineberg also pointed to a list of conflicts that stand in the way of the public health – conflict of commercial interest (e.g. tobacco), conflict with personal preferences, and conflict with religious and cultural beliefs. To view the video, click here. October 2, 2008 Dr. Fried addressed the importance of the life course approach to health promotion for the next generation and how public health for an aging society benefits all ages. The population over 65 years old currently stands at 12%, but is expected to increase to 20% by the year 2030. "As such, public health or adding life to years is key,” says Dr. Fried. Now living one-third of their lives after retirement, the 65+ population have few meaningful roles but many contributions to offer society, because they are the best educated and experienced, with time to give back to society. “Unfortunately, the healthcare system is not ready for the aging population, while great opportunity exists if we change our frame of reference,” notes Dr. Fried. She cites programs for health promotion in the inner city including Experience Corps, which was developed by Dr. Fried in Baltimore. The model is considered one of the best resources for the field of public health to utilize the contributions of an aging society. To view the video, click here. October 16, 2008 Dr. Frieden offered his insights on the health issues we face in New York City, around the country, and across the globe. The world is facing a turning point in non-communicable diseases (NCD), with death rates projected to grow substantially by the year 2030. The developing world especially can learn from what we know and change the trajectory, especially in China where 80% of deaths are now from NCD, created mostly by tobacco, alcohol, and lack of exercise. Dr. Frieden points out that tobacco, in particular, which kills more people than HIV and TB combined, is more amenable to intervention than any other high priority public health issues. To view narrated slides, click here.
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