Health of the Public: An Academic Challenge

Field of Work: Involving academic health centers in the health needs of surrounding communities

Problem Synopsis: An August 11, 1989 article in the Journal of the American Medical Association (JAMA), "Academic Medicine as a Public Trust," laid out a challenge to academic medicine to fulfill its public trust: "Academic medicine…has been relatively unresponsive to a number of vexing public problems, including…substandard indexes of population health…. The central issue is how well academic medicine is fulfilling its responsibilities to the public."

Synopsis of the Work: Health of the Public: An Academic Challenge co-funded in 1992 by the Robert Wood Johnson Foundation (RWJF) and The Pew Charitable Trusts, challenged academic health centers to broaden their mission to address the health needs of their surrounding communities.

Evaluation Findings

  • A 1996 evaluation, conducted by Norman H. Edelman, MD, of the University of Medicine and Dentistry of New Jersey, Piscataway, N.J. and Nurit Guttman, PhD, New Brunswick, N.J., found:

    • The program had succeeded in infusing Health of the Public concepts into the academic community, creating a supportive network of institutions engaged in the program, and helping Health of the Public proponents to advance their academic careers.
    • Within individual institutions, Health of the Public project sites made strides in curricular reform, collaboration between fields, and partnerships with community organizations.
    • The program was less successful in pulling the Health of the Public projects together into a fully integrated network, collaborating with social and behavioral sciences, and gaining national visibility and influence.
    • The program targeted discrete sub-groups (e.g., specific demographic groups or enrollees in a particular managed care plan), rather than whole geographical communities. Targeting sub-groups had important repercussions in shifting Health of the Public's focus away from the overarching health concerns of the community and back toward the traditional disease-centered model of biomedicine.