An Unhealthy State of Affairs
By Amy Blakely
Tennessee is not a healthy state.
According to America’s Health Rankings, an annual state-by-state analysis published by the United Health Foundation, nearly a third of the population is obese. Nearly a quarter smokes. The state is among the nation’s worst in terms of infant mortality rates, premature deaths, cancer, and cardiovascular deaths.
Are Tennessee health departments using this information to implement programs and improve residents’ health?
Research under way at UT Knoxville’s Center for Public Health is trying to answer this question—not just for Tennessee but for all states.
Started in 2007, the center is a collaboration of six UT colleges and institutes: Education, Health, and Human Sciences; Nursing; Social Work; Veterinary Medicine; the Graduate School of Medicine; and UT Extension. The center is housed in the College of Education, Health and Human Sciences, and overseen by a board of the six deans.
Paul Erwin, the center’s director, is a public health physician who spent 16 years working at the Tennessee Department of Health, 12 of those as regional director for the East Tennessee Regional Health Office.
The center’s mission is threefold: to identify and pool the resources related to public health campuswide; to expand teaching, research and outreach efforts; and to encourage partnerships with local, regional, and state public health programs.
In February 2009, the center won a $133,000 year-long grant from the Robert Wood Johnson Foundation to determine if public health programs are improving health across the U.S., and if so, how. The Robert Wood Johnson Foundation is the nation’s largest philanthropy devoted exclusively to improving the health and healthcare of all Americans.
Erwin, along with researchers in UT’s College of Social Work and College of Nursing, is looking at public health statistics, surveying top health officials in all 50 states, and conducting in-depth interviews with public health professionals in 10 states.
“We are trying to identify whether state officials are using health data to make decisions about where to place their resources—and whether their decisions have made a difference in people’s health,” Erwin says.
According to Erwin, the results will be valuable to the people who run health agencies, as well as to legislators and policymakers who fund health initiatives.
“If states don’t pay attention to these health statistics, that has implications for the organizations which compile reports, such as America’s Health Rankings, he says. “For instance, it might prompt them to make changes in the reports so they have more relevance for public health providers.”
On the other hand, states that have used the statistics to implement successful programs can be examples to show other states how health data can be used to set policy, allocate resources, and justify expenses.
Such research is even more important in hard economic times. “State and local health department resources are tied to state budgets, and when states’ economies falter, those resources are often reduced,” Erwin explains. “One of our longer-term research aims is to help officials determine how to best use the funding they have and determine where they can make cuts with the least impact on public health.”
Beyond UT’s Borders
While the Center for Public Health has been working to interconnect campus resources, it’s also made a broad effort to network beyond the university.
The center is the secretariat for the East Tennessee Forum on Public Health and Preventive Medicine, a group that encourages UT faculty to confer with public health leaders from regional and local health departments about public health issues and to identify potential areas for community-based research.
“The center’s involvement provides the forum with a more formal structure and with greater stability in terms of planning,” Erwin says.
UT benefits greatly, too.
“Such networking has already resulted in numerous research projects as well as thesis and dissertation topics for graduate students,” Erwin says. “It’s increased the opportunities for our students to get valuable hands-on experience and, as a result, we’ve strengthened UT’s ties to governmental public health agencies.”
Erwin also has worked to link the Center for Public Health with county health councils throughout East Tennessee. County health councils, which have existed for more than 15 years, are groups of local citizens who are concerned about community health and well-being.
Accompanied by graduate students, Erwin periodically attends different county health council meetings periodically. These visits have allowed Erwin and the students to get a good read of the public’s concerns and make local contacts that could be useful for future research.
All of this networking—inside UT and with the community—is laying the groundwork that may one day allow the university to establish a School of Public Health in Knoxville.
“Our center’s goal—the goal of a future School of Public Health,” Erwin says, “is to bridge the gap between academic research and public practice so that, together, we can improve the public’s health.”Tags: Center for Public Health • Paul Erwin