The National Board of Chiropractic Examiners asks questions about it. Chiropractic college curricula discuss it. Dynamic Chiropractic runs a column on it. And yet perhaps few chiropractors could really peg a role for our profession in it if asked.
Chiropractors probably look back with something less than fondness on their academic experience with public health. Courses covering coliform bacteria, food inspection, and the water purifi-cation process (remember the Schmutzdecke?) often failed to spark the imagination or provide insight into the role chiropractic could play in this often misunderstood science of public health.
As important as those items are to public health and those courses were to our education, chiropractors need to have a real understanding of the role they can and do play in public health. What can we do? Is there a role for chiropractic in public health? Instinctively, we all feel the answer must be "yes." We believe in health, in the value of the individual, in the importance of successful communities and families. As chiropractors, we believe health is more than the absence of disease; that individuals and communities should flourish and reach their full potential.
Not incidentally, this belief in a fuller definition of health is shared by public health practitioners. The American Public Health Association (APHA), the world's oldest and largest public health organization, has as its mission to "promote the scientific and professional foundation of public health practice and policy, advocate the conditions for a healthy global society, emphasize prevention and enhance the ability of members to promote and protect environmental and community health" (emphasis added).
The APHA has a vision of health enhancement and disease prevention on a wide scale. Members of the APHA recognize that the greatest advancements in health and longevity in the U.S. have come not from medical intervention, but from community-based measures that have created healthful conditions. In fact, the APHA refused to admit medical practitioners into the association until about 50 years after the organization started, wary of a shift in emphasis to treatment from prevention. Public health practitioners recognize that though 97 percent of U.S. health expenditures are spent on treatment, greater resources should be spent on enhancing health and preventing disease - where the biggest impact could be made. Chiropractors agree. This is a vision of prevention and promotion that chiropractors and public health practitioners fully share.
So, here we are. Chiropractors and public health providers have a similar definition of health. What do public health professionals believe their role is in enhancing health, and how can chiropractors contribute? The groundbreaking 1988 Institute of Medicine (IOM) report,
The Future of Public Health, described the three fundamental functions of public health to be assessment of community health needs; policy development supportive of health; and assurance that needed services are provided.
The Centers for Disease Control and Prevention (CDC) later outlined 10 main categories of activities public health practitioners perform, and then grouped them under the IOM's three functions. While specific ways in which chiropractors fill these functions will be addressed in a later article, it is clear these are tasks that chiropractors can help accomplish.
The IOM stated that public health is an "organized community effort to address the public interest in health by applying scientific and technical knowledge to prevent disease and promote health" (emphasis added). Many chiropractors are already on board with APHA. Many chiropractors are already into public health practice at heart and don't even realize it! Won't you join with us officially as we work with public health practitioners through the APHA and other venues? To become a member of the APHA (and its Chiropractic Health Care Section) and work with like-minded individuals from many professions and backgrounds, see www.apha.org/membership/categories.htm or contact Mrs. Lori Byrd Spencer, Chiropractic Health Care Section membership chair, at
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A subsequent article will cover specific ways chiropractors fill public health needs per the definitions of the IOM and the CDC. Meanwhile, consider joining the APHA! Chiropractic and public health belong side by side: two great tastes that taste great together.
Dr. Jonathon Egan is a graduate of New York Chiropractic College and current chief of staff of the NYCC Campus Health Center. Formerly a clinician at the VA facility in Rochester, N.Y., he now chairs the Seneca County Board of Health.