The context and role of the US school of public health: implications for the United Kingdom.

Several UK medical schools have reorganized academic public health in 'schools of public health' or 'health sciences'. This paper considers the implications for the United Kingdom of the US concept of schools of public health independent of medical schools. These schools provide multidisciplinary research environments with scientists from laboratory and population-based disciplines competing successfully for federal research funds on projects ranging from basic science (e.g. biochemistry or genetics) to public health policy. Few public health academics see the expenditure of a trillion dollars per year on health care as a priority for public health. These schools have excelled in research, but not in leadership of service public health, so academic and service public health goals have diverged. In seeking the research advantages of the US system, the strengths of the UK one, including the relatively close links between public health and medicine and academia and service, together with a focus on applied work, should not be lost.