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Wednesday, 3 September 2014

Public Health in Canada – for students and trainees, a promising future.

University classrooms are back in swing, PhD students are arriving to aspirations of new discoveries, MPH students are arriving at the 14 public health schools in Canada,  and other graduate students entering programs in science of epidemiology, health administration or other related public health fields. New residents in public health and preventive medicine have been at the books for a couple of months in the 13 Canadian programs. Nearly 1000 future physicians are showing up for their first classes of training in 17 schools, while twenty times this number are entering nursing programs.   Innunmerable other health professional programs are integral to and contribute to the multidisciplinary world of public health training. 
The health care business is booming and the training of the workforce is an integral part of investing in our future.

The number one question most students ask – is will there be a job for me?

The demand for health services is not contracting.  Public health opportunities wax and wane with the economy and political stripes, more so than treatment or continuing care services where demand continues to increase.  Hence fluctuations in public health opportunities are to be expected, however lots of promise remains.

The past fifty years have seen smoking rates plummet, infant mortality rates approaching theoretical minimums, disease rates for most diseases consistently dropping, injury rates going down… .  In fact most measures of public health would suggest that the heavy lifting has been done.  (Essentially for physical ailments only rates for diabetes and alcohol related deaths have gone up with early signs diabetes is peaking).  

Mental health is finally getting a level of attention that it deserves and an area deserving even more focused public health attention.

Societal issues such as poverty, inequity, violence, social supports, resilience amongst a slew of health promotion and wellness related spinoffs receive at least rhetorical attention. 

Risk behaviours including inactivity, poor nutrition and mood altering substances are receiving more attention and remain a focus of those incriminating personal choice. 

Despite, or in spite, of our efforts, the future for children has is not rosy.  Childhood vulnerability at school start has increased in just the past ten years.

The point of the last five paragraphs being that while disease specific work has been highly successful and something that public health should celebrate as the major contributor to reductions, there is plenty of work to do in realms that are under-serviced currently. 

A favourite quote from DrPHeatlh.   The four reasons why we are assured continued public health work in the face of such success:

·         Bugs evolve faster than humans – control of communicable diseases while the greatest success of public health, will remain central to public health work.
·         Humans are smart – they invent new technologies which present new public health problems.  From current issues like e-cigarettes to transportation and recreation technologies like cars, skateboards and skis to drivers of sedentary lifestyles in computers, television, and gaming.   The human mind is filled with inventions that bring value and may have negative health consequences
·         Humans are not always smart, they make less than healthy choices that contribute to poorer health.  Whether using substances, gambling, fast foods or risky recreational activities – there is room to alleviate the pain and suffering associated with unhealthier lifestyles.
·         Humans are animals.   Darwin was right with the survival of the fittest.  In the human context while socially we tend to our needy far more than most species, it is still a dog eat dog world with winners and losers that engage in war, measure success in wealth, and put “self” before others in seeking dominance. 

So, for all those new students to the vocation of public health, a true heart felt welcome.   There is a whole world of opportunity ahead, filled with things we can see and an exciting menu of issues that we can’t even imagine today. 

Good luck and hold true to the values that brought you to where you are today. 


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