Preparing public health leaders for the 1990s.

Public health leadership is urgently needed throughout the world. In most local, provincial, and national jurisdictions, such responsibility has been assumed by doctors of clinical medicine, who know much about treatment of disease in individual patients but very little about prevention of disease and promotion of health in populations or the management of health systems. Effective leadership in public health requires a new profession, with generalized education in the basic tools of social analysis, health and disease in populations, promotion of health and prevention of disease, and health care systems and their management. More than 40 distinct scientific subjects have been developed in these fields over the years, and current faculties are qualified to teach them. To provide this education would require about 5 years of academic and field studies, after a bachelor's degree. Schools of public health now train doctoral-level specialists who are prepared in the PhD tradition for academic posts. These schools should also develop educational programs for doctoral-level generalists who are qualified to provide community health leadership at local, provincial, and national levels.