Breaking the "invisible-profession" paradigm.

Last June, during the NEHA Annual Educational Conference in Atlantic City, New Jersey, two focus groups, consisting of affiliate presidents from the states, as well as many NEHA Board of Directors members, discussed the invisible-profession theme. Many of the comments in those group meetings focused on workforce issues.

The discussions were animated, and agreement was unanimous about the need to better market the environmental health profession. Among the many issues and ideas that were discussed, the following comments centered on the workforce:

* The number of eligible students is dwindling each year.

* Some states will have retirement rates of over 50 percent in the next few years.

* Some participants felt that we need to recruit earlier than college age and reach out to high schools and middle schools.

* Some commented that the name "sanitarian" connotes garbage pickup to high school and middle-school students.

* One participant discussed a state governor who also misconstrued the sanitarian title--when asked to give a few words to a group of environmental health personnel on signing an environmental health week proclamation, he thanked them for doing a great job of cleaning the streets!

* The need to work more closely with community colleges was mentioned.

* A suggestion was made that retiring professionals could carry the environmental health message into schools and community colleges to attract new students to the field of environmental health studies.

The focus group participants compared environmental health professionals with nurses, whose workforce crisis is well understood and widely known. Part of this good understanding comes through the use of "nurse" as a general title. Perhaps the misunderstanding of our environmental health work stems in part from the lack of a consistent title and message?

In a pilot project of the Association of State and Territorial Health Officials (ASTHO) that I'm currently involved with, we are attempting to conduct a census of state environmental health and nursing personnel. During construction of the draft survey, there was a lot of discussion about the various environmental health titles that are currently in use and also about the fragmentation of duties and programs. These variations make comparisons of staffing numbers across the states very difficult. Without a true enumeration of the professionals working in our field, it is difficult to make broad statements about trends and future needs. I know I am on thin ice here discussing our professional title, but maybe these thoughts will begin the discussions again!

Some focus group time was given to thinking about a consistent logo and tag line that could be used to market environmental health. The logo recently produced by the National Association of City and County Health Officials (NACCHO) was mentioned (for details of this logo, please see http://www.naccho.org/advocacy/marketing/LocalPublicHealthBrand.cfm), but some would like to see a slight deviation to allow some differentiation of environmental health. The one-liner used by the National Center for Environmental Health (NCEH)--"Environmental Public Health ... touches everyone's life every day"--was popular with the focus group. As with our professional title, I hope that this column will provoke some discussion of an appropriate logo and marketing tagline for the environmental health profession.

As a member of the NEHA Board of Directors and the Environmental Health Workforce Consortium, I represented NEHA earlier this year at a workforce summit conducted by the Council of State and Territorial Epidemiologists (CSTE). The invisible nature of many public health jobs again surfaced as a major theme of the discussions. There were, at the meeting, representatives from a number of other public health associations, such as the American Public Health Association (APHA), the Association of State and Territorial Health Officials (ASTHO), the Association of Public Health Laboratories (APHL), and the Association of Schools of Public Health (ASPH).

The purpose of the meeting was to provide an update to attendees about CSTE's current workforce initiatives and to hear from the other associations about their workforce priorities. The facilitated discussion led to the designation of highest-priority programs and projects for CSTE to follow for the next three years. During the various presentations, representatives of several other disciplines within public health described themselves as invisible. The area of marketing of the field of epidemiology surfaced as a main priority.

I share the outcomes of this meeting to show that we in the environmental health world are not alone in needing to better market our profession to attract and keep the brightest students in our field of work. In fact, I believe environmental health administrators will face increasingly stiff competition for students trained in the sciences from the private sector and also from within our own public health ranks. On a more positive note, there is the possibility of NEHA working alongside other associations in our marketing endeavors since there is alignment on these workforce needs and on the need to decrease our collective invisibility.

The invisibility theme surfaced again for me when, as an environmental health director in Georgia, I became involved in a new group of state environmental health directors coordinated by ASTHO. This group recently met face-to-face in New Orleans. One of the subgroups set up under the main umbrella group is a marketing committee headed by Clyde Bolton from Kentucky. Clyde has tapped into Eastern Kentucky University resources, in particular a CD that promotes the environmental health program and encourages student diversity within that program, to create a promotional CD for the state agency. This group has also created a new Web site clearinghouse for sharing of promotional materials. I'm hopeful that the NEHA special committee on marketing will look at combining efforts with this group to maximize our collective effectiveness.

Another possible alignment of the NEHA marketing group and the state environmental health directors group is to think about the work that can be done to educate policy makers about the important work done by environmental health professionals. While those of us in the public sector have to be careful to maintain some distance from policy makers to avoid the accusation of direct lobbying, much needs to be done in putting together educational materials for the policy makers and their staff. Some of the NEHA affiliates have organized themselves to create a legal lobbying arm of their association. The lessons learned by these organizations could be tweaked to further the education and outreach efforts toward policy makers as part of the marketing strategy for decreasing the invisibility of our profession.

Robert G. Blake

Rob Blake R.E.H.S., M.P.H.

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