A question of survival.

As environmental professionals and professionals in environmental health, we have all benefited from those who preceded us in protecting the public health and the environment. Our predecessors worked to ensure that "that which surrounds us" doesn't adversely affect our health and well-being. Those giants of public health and environmental protection have shown us that having core beliefs, an understanding of public health, a vision of what is important, and the will to present one's ideas for public discourse--and then acting on these beliefs and visions--benefits all. We now are at a point in our history where we have to take those lessons to heart. We need to make sure that their legacy does not dwindle into the murkiness of mediocrity.

Organizations such as NEHA and state affiliates, together with local and state public health and environmental protection agencies, are facing many challenges in our societal evolution: Challenges such as dwindling membership, loss of institutional memory and strength, retirement of experienced professionals, cutbacks in funding, and the lack of formal leadership development are challenges to our survival as a professional organization and, in some communities, even as a profession.

Prior to our recent Annual Educational Conference (AEC) in Anchorage, I sent out a questionnaire to the presidents of all NEHA affiliates asking them to list the three most important issues facing environmental health in their state and the most important issues facing their affiliates. The responses were varied, but some very interesting common issues presented themselves.

The most important issues seemed to revolve around financial problems--as we might expect in today's "do-more-with-less" economy--that could ultimately lead to a degradation in the quality of life of our communities.

An aging workforce and fewer students enrolled in accredited environmental health degree programs also are problems for state and local public health and environmental health programs, as well as for professional organizations like NEHA and NEHA affiliates.

The most experienced members of our profession are being offered early retirement incentives, and with them goes a tremendous body of knowledge and history, particularly in the areas of specialization. After these retirements, hiring for the vacated positions is often delayed or even prohibited, resulting in further dilution of staff and the ability of the remaining environmental health professionals to meet the challenges of new technologies, new food preparation processes, more deadly environmental insults, and, of course, the demands presented by possible terrorist events. Even when there is authorization to refill existing positions or to fill new positions, ready-to-hit-the-ground-running environmental health professionals who are classically trained in core public health competencies are not available--or the salaries offered by public health and environmental health agencies are too low to entice them into the field. Public agencies with dwindling budgets find it hard to provide competitive salaries. Potential employees with the requisite training are lured away by private industries that can afford to pay higher salaries. This situation may be good for environmental health professionals, but it is not so for public agencies and consequently for the public.

A similar trend has been apparent in our accredited schools of environmental health and public health, where enrollment has been dwindling for the past decade. Some schools have even contemplated dropping their accredited environmental health programs because of low enrollment. The demand for academically trained environmental health professionals is there, but the supply is low. On a brighter note, in the last few years the bleeding has stopped, and the schools offering an environmental health curriculum have seen some increases in enrollment.

We as professionals need to do more to encourage young people to consider environmental health as a vocational goal and to have them enroll in schools with accredited environmental health programs. I will discuss this topic as part of a future column dedicated to the marketing of our profession. Once young people enter the workforce, we need to find innovative ways to get them to join and participate in NEHA and state affiliate activities. This process could include initiatives such as reducing the registration fees for those attending their first educational conference or offering free affiliate membership for one year to newly hired environmental health employees. We need to recruit and keep these trained individuals in our workforce and in our state NEHA affiliate organizations.

Many public agencies are hiring non-environmental-health-trained people to fill the void in students graduating from accredited environmental health programs. These individuals who want to work in environmental health might, if adequate core competency training could be provided, eventually become assets to public health agencies. Believe it or not, many of the pioneers of our profession got started under this model. This approach is not possible, however, in an era of budget cuts, when the first thing to be cut is training. In the past, agencies were able either to fund or to assist staff to pursue advanced degrees in environmental health. As a young person employed in environmental health but having no formal training in this specific area, I was fortunate that my agency allowed me to take courses in public and environmental health while on the job. Some of my colleagues were even provided tuition and living-expense assistance. Most, if not all, of these programs no longer exist. The key to our continued survival is either adequate advanced degrees or affordable continuing-education opportunities, or both.

CDC has recognized this "void" and has embarked on a course of rebuilding the public health and environmental health infrastructure through public health core competency training. More of this kind of training is needed, as well as funding of advanced degrees in environmental health.

Some affiliates also are taking the initiative to recruit and retain members by adopting new approaches to training and offering new opportunities. They are contracting with state and federal agencies, which provide the funding for continuing education. These affiliates are doing rather well. Among their offerings are bioterrorism training, epidemiology, disease recognition, plan review, innovative and alternative subsurface sewage disposal, the HACCP method--and the list goes on. Affiliates pursuing these educational initiatives have certainly proven themselves an asset to the sponsoring agency and to the public.

NEHA is trying to help the affiliates through the establishment of a Speaker's Bureau that lists excellent speakers from various areas of public health and environmental health. Sharing of membership lists between state affiliates and NEHA can be used to help recruit new members. NEHA national officers, regional vice presidents, and NEHA's executive director are available to attend affiliate meetings and discuss NEHA programs as well as a variety of other timely subjects.

Yes, the challenges are there for local and state public health and environmental health organizations, including NEHA, NEHA affiliates, schools of public health, and schools with accredited environmental health programs, to become visible, to encourage young people to consider environmental health as a career, and, once those young people enter the profession, to encourage them to participate in professional organizations like NEHA and its affiliates. In this way we make it possible for these new professionals to advance and grow in the field of environmental and public health. Will you take up the challenge?

James Balsamo, Jr., M.S., M.P.H., M.H.A., R.S.

[ILLUSTRATION OMITTED]