The 1997 DeHaan Lecture was given by
Noreen M. Clark, PhD
Dean of the University of
Michigan School of Public Health
Opening Remarks byDr. Ronald Braithwaite
Associate Professor, Department of Behavioral Sciences and Health Education
April 8, 1997
Rollins School of Public Health
Noreen M. Clark is Dean of the University of Michigan School of Public Health and Marshall H. Becker Professor of Public Health. Specializing in research on self-management of chronic disease, Dr. Clark's studies of asthma self-management have contributed to the research literature and the field of practice by demonstrating that educational interventions can decrease hospitalizations and medical emergencies among low-income families. Her work has resulted in archetype educational programs being distributed nationally by the National Institutes of Health and the American Lung Association.
Among her many contributions to the fields of health education and promotion, Dr. Clark has served as president of the Society for Public Health Education and as chair of the Public Health Education Section of the American Public Health Association. She is the editor of Health Education and Behavior, the pre-eminent scholarly journal in the field of health education. She is also the recipient of the Distinguished Fellow Award, the highest honor bestowed by the Society for Public Health Education; the Health Education Research Award, conferred by the National Asthma Education Program; and the Derryberry Award and the Distinguished Career Award in Health Education and Promotion, both given by APHA.
Dr. Clark has extensive international experience. Her research has focused on development and testing of interventions designed to improve health status, quality of life, and collaborative activity among rural women in Kenya and in the Philippines. In addition, she has served as a consultant in education and evaluation for a range of international organizations including the Ethiopian Women's Welfare Association, the Ministry of Education in Nepal, the Asia Foundation in Pakistan, the World Bank, and the United Nations Development Program.
From the Fall 1997 issue of Public Health magazine.
DeHaan Lecturer puts health education in context
In an era of health care where the focus is on time and money, Noreen M. Clark has proven that health education can actually reduce costs at the same time it improves health. "My strong conviction is that unless we attend to the social and behavioral aspects of our health problems, we will never see dramatic change," says Clark, dean of the University of Michigan School of Public Health.
Clark, a noted researcher on self-management of chronic disease, delivered the annual Virginia S. DeHaan Lecture on Health Promotion and Education at the Rollins School of Public Health in the spring. She summarized her studies of asthma self-management to demonstrate that educational interventions can decrease hospitalizations and medical emergencies. Her work has led to educational programs distributed nationally by the National Institutes of Health and the American Lung Association.
In her lecture, Clark examined the broad context of public health work today, with demographics at the head of her list. "In the United States, we are becoming more diverse and pluralistic," Clark says. "In the 1990s, 85% of new entrants into the work force are people of color." The demographics of age also are rapidly changing. "We are seeing a broader range of ages," she says. "By the early 21st century, more than 1 million Americans will be 100 years or older. These demographic changes present challenges for a society that will be simultaneously caring for children, parents, and even grandparents."
Other contextual considerations that influence the field of public health, according to Clark, are the internationalization of the United States, environmental issues, and ythe growth of knowledge and technology. "Land, money, and guns drove our economy in the past," Clark says. "Ideas will drive it in the future."
Although Clark outlined what she calls "stunning achievements in public health," she also discussed challenges to the field. She shared some alarming statistics. For example, 19 other countries have better infant mortality rates than the United States. Rates of immunization in this country need to be improved, a fact highlighted by the 40,000 US citizens who will die of influenza this year. Drug-related illnesses are rampant here, and the United States leads the world in suicide and homicide rates.
"We are not going to realize change in these numbers until we change behavior," Clark says. "Interventions must focus on population-wide strategies, on behavior and the physical and social environment."
Clark identified six areas in which public health professionals must be especially competent to enact change. In addition to an understanding of the intricacies of health care financing, they must be comfortable in business-oriented environments, "to work in the hard-nosed world of the bottom line while maintaining their humanism," she says. They need to be media and computer savvy and to know how to use statistics correctly. Finally, public health professionals need to be problem solvers who have the "people skills" to navigate cross-cultural and interdisciplinary fields, Clark says.