New Problems in Community Health: Implications for Residency and Training Programs

Abstract

Schistosomiasis in Egypt and slum housing in New York City are examples of the kinds of problems which require public health workers to look beyond conventional medical horizons. The role of public health workers needs to be expanded beyond the traditional administrative boundaries for government and the academic world. The writer advocates changed and closer institutional relationships between training centers and client communities, and more active roles for a greater number of community health professionals as part of their graduate educational experience. This is consistent with the idea that educational training programs have to prepare their graduates for career patterns with greater action and initiative. The health officership, with its far-reaching mandate for involvement in all aspects of community health, is suggested as an instrument through which academic involvement in community health can be mediated. At the same time, the role of the health officer needs to be redefined as the community's “ecologic triage officer.” Involvement with the health officer's problems will broaden an institution's approach to community health because these problems reach beyond medical care. The professional roles associated with many of the major new problems of community health will require closer structural relationships between governmental-type field settings and academic residency and training programs.