by Brooks McCabe and Rahul Gupta, MD

Public Health is about people and how they live. When public health is at its best, people aren’t aware of it. The Institute of Medicine(IOM) defines public health as “the efforts, science, art, and approaches used by all sectors of society to assure, maintain, protect, promote, and improve the health of the people.”1 For too long, we have underappreciated the fact that the overall health of our state is determined by not only the health of individuals but the health conditions in the communities where they reside. The so called ‘social determinants’ of health play a critical role in preventing our citizens from achieving their full health potential.2 The social determinants are the complex, integrated, and overlapping social structures and economic systems that include the social environment, the physical environment, and health services. These structural and societal factors are responsible for most health inequities. Poor health practices, limited health care access and little or no preventive care has resulted in West Virginia having high national rates of heart disease, hypertension, diabetes, chronic lung disease and obesity.

Since the early 1900’s, while the lifespan in the United States has increased by more than 30 years, 25 of those years are attributed to advances in public health initiatives such as vaccination, healthier mothers and babies, and public health approaches to traffic safety and seatbelt use.3, 4 This connection between individual health (health care), community health (public health) and policies that eventually impact population health illustrate the significance of having a comprehensive systems-based coordinated approach to improving the health of West Virginians. It is this connection that a School of Public Health brings to West Virginia.

Comparable to the despair from communicable diseases and epidemics in the last century, the wave of chronic diseases has poised itself as the new epidemic in the new century.5 Nowhere is this more apparent than in West Virginia. Our state is being brought to its knees by the high cost of health care for its citizens while we remain at the bottom of statistics nationally in most disease outcome indicators. Like many other states today, if West Virginia would become financially insolvent, the major share of the blame will be due to the healthcare costs. The state’s inability to afford these ever-increasing costs prevents West Virginia from rendering the best individual medical treatment necessary to overcome a chronic disease epidemic of this magnitude. The foundation of our success in combating this new epidemic lies in learning how to integrate research, inter- and intra-disciplinary scholarship, medical care, community leadership, and public engagement in a way that challenges the conventional perspective.