The magazine of the UW School of Public Health

From the Editor

Public Health: Constant & Changing

Susan Allan

Throughout my own 25-year career in public health, the field has struggled with how to answer the question, “What is public health?” This issue’s reflections on the past 40 years of public health in the Pacific Northwest reveal a practical answer: Public health keeps the focus on the health of the population and the community, while the programs, methods, staffing, and priorities change to respond to evolving circumstances.

This theme is echoed in many of the articles in this issue: that the core activities, values, and goals of public health have remained constant, while the health problems, social and political circumstances, and resources have changed and evolved, in some cases in ways that couldn’t have been imagined by previous public health generations. Forty years ago the use of computers was rare and extremely expensive, telephones were tethered to wires, the World Trade Center towers were just being built and the US adult obesity rate was 14 percent. No one in this region was concerned about HIV, West Nile virus, SARS, or bioterrorism, and no one could imagine the current adult obesity rate of 34 percent. But then and now, there were valued public health programs to control tuberculosis, to improve childhood immunization, to promote healthy behaviors, and to fluoridate water—all important and unfinished work of the present day.

We are pleased to have columns in this anniversary issue reflecting the experience and thoughts of three leaders who have helped shape public health in our region and nationally—Bud Nicola, Kristine Gebbie, and Maxine Hayes. They take a long view of the field, reflecting on the past and identifying trends that will shape the future of public health. A two-generational viewpoint is provided by a young professional who has followed her mother into Public Health.

Peer-reviewed articles examine the evolution of public health laboratories, tribal rights, infant feeding practices, and environmental and occupational health. The cross-disciplinary nature of public health is evident in articles contributed by professors of economics, urban planning, and law.

The printed version of this journal is only the beginning of the exploration. Our Web site,, contains additional peer-reviewed articles describing the evolution of public health in the region, particularly in the area of information technology. Librarian Laura Larsson has compiled an annotated bibliography that, as always, provides a valuable resource for those in our field.

One of the goals for this journal is to strengthen the connections among the public health practice and academic communities of the six Northwest states. With this issue, our Web site launches an interactive forum, where you can continue the conversation about the topics our authors raise. We look forward to hearing our readers’ viewpoints and examples of local implications of the issues raised in our articles and editorials. Please stay in touch.

Susan Allan, Editor-in-Chief
Director, Northwest Center for Public Health Practice
UW School of Public Health