Demand for Deliverables Identified in Goals
The pandemic we face in HIV/AIDS and STD's as well as the critically high prevalence rates that exist in cardiovascular disease, cancer, strokes, violence (school and youth violence) and other critical areas demand solutions. As stated previously my survey research with highly trained and community based practitioners revealed that from ninety (90) to ninety-eight per cent (98%) of the morbidity and mortality from the above disease entities is preventable! This reality therefore sends a strong and fervent plea for primary prevention curriculum, training of public health personnel. Some public health programs have observed and contacted me regarding community-based curriculum suitable to prepare practitioners for practice in the inner cities of America. Drew University in Los Angeles, for example; we are currently assisting in starting their community based MPH and potentially a Dr.PH program.
The twenty-seven (27) accredited schools of public health in our survey in 1996 stated that they did not teach community based practice at the doctorate level. Agencies and institutions that serve low-income minority - people of color and low-income persons of all races are seeking help due to the high patient loads and caseloads they carry. Without prevention practitioners that can emphasize and educate communities on wellness and prevention programs the heavy patient loads will eventually bankrupt the managed care system. Additionally, the sicker patients will not be accepted (preexisting conditions) and will add to the tax burden with uncompensated care at urban hospital centers. Hence, the morbidity and mortality rates that grow out of this reality become even more unacceptable because the vast majority of the diseases are preventable.
Cultural competence is a critical need for public health practitioners. How can anyone plan prevention programs, social marketing and/or awareness campaigns without full knowledge of the culture, values, health attitudes, health behaviors and related variables? It simply cannot be effectively done without cultural competence. Therefore, to lower the extremely high prevalence rates of preventable disease, we must move quickly to prepare cross-cultural competence in public health which lags behind all behavioral sciences and human service disciplines in this area such as psychiatry, psychology, social work and nursing.
The training materials, monographs and all other materials are in demand. These materials are not available or made accessible for schools and programs in public health. The related research will further develop the science needed to energize more health behavioral change theory building. We also, with more research, will be able to design and test for efficacy practice sets and modalities that will be most productive as we further redefine public health practice.