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The invisible profession.

In the January/February Journal, I noted that we take our responsibility to provide our members with maps that show them the way into their future very seriously. In follow-up to that pledge, we're extremely pleased to present in this issue of the Journal, the provocative article, "Redesigning Local Environmental Health Programs." This article explores many of the challenges you will be facing as environmental health programs adapt to the changing realities of this decade and beyond.

I won't bother to repeat here what you can read in the article. What I would like to do, however, is to share with you some of the extremely interesting insights that were shared with me by Dr. L. Duncan Saunders, who is the corresponding author on this paper. The "behind the story" story that he enlightened me with was in many respects as fascinating as the article itself. I hope that the following report of our conversation adds even more detail to that "map" we promised you.

I asked Dr. Saunders if he would take a couple of steps back to reflect on what he learned about our profession as a result of conducting this study. I wonder if his answer might surprise you.

Without hesitating, he responded that he was completely taken by "the almost invisible nature of environmental health programs." He mentioned that as a result of this study, he came to the surprising realization that most of our programs are taken for granted by both those who make policy for us and by those whom we serve.

He noted that he had met many dedicated and top-caliber environmental health professionals over the course of his study. Yet he offered that despite the expertise, care, and concern that this profession exhibits, we tend by and large to be viewed - if at all - as nothing more than enforcers.

This troubled him. He explained that if the perception of those who practice environmental health does not take into account the analytical and problem solving capabilities of this profession, then as a profession, we may be courting disaster. More specifically, he suggested that if our claim to fame was reduced to nothing more than enforcement, then it was not that difficult to imagine this profession transitioning into an assembly of technicians.

He continued that if that was our destiny, then the justification for even having environmental health programs would be undermined. He explained that it would be easy for policy makers to relocate the enforcement remnant of our programs into other departments which had neither an environmental nor even a public health orientation. That in turn would place whomever was left in this profession in a position to support goals and causes that were not necessarily related to environmental health.

As I listened intently to what he saw in his crystal ball, I was stunned.

He elaborated that it was critical for our programs to change with the times. In the actual article, you can read about the types of changes he and his study team determined were needed in order for environmental health programs to remain relevant and to prosper.

Returning to this behind the scenes discussion, however, and as if he didn't already have my attention, he stunned me again when he mentioned that to some extent we might be guilty for our own demise. By that he meant that as he and his colleagues had gone about this study, he had come to appreciate that within the profession there are two very different and distinct schools of thought in regards to our professional identities.

He characterized one of these schools as having an inspector/enforcer outlook. This particular outlook saw and defined environmental health in traditional terms, and further, advocated that the heart and soul of our work lay with inspection and enforcement actions. (Dr. Saunders, by the way, was careful to emphasize that he personally felt that the act of inspection/enforcement would always be an essential part of the environmental health professional's armamentaria. Where he departed from this school was in his belief that this activity should be viewed as but "one tool of many" available to the professional.)

He characterized the other school as being made up of problem identifiers and problem solvers. He noted that these people were typically environmental health officers and managers. This school, he explained, tended to look upon the practice of environmental health in terms of the opportunity to utilize an array of tools. As mentioned in the article, this school is more oriented toward helping a community through the application of health-promoting intervention strategies, market incentives, and collaborative problem solving.

I doubt you would be surprised if I told you he felt that the future of the profession and the ability of our people to have an impact on issues was far more promising under the leadership of the problem solvers.

Dr. Saunders was quite emphatic when I pressed him on what would happen if we failed to follow the outlines of the model that he and his colleagues developed. His exact words were that he believed environmental health programs would be "squashed out," and that the remnants of these programs would be absorbed by entities not oriented toward environmental health goals.

He actually made a rather passionate argument with me in which he implored the profession to increase its visibility and stature, and focus its work more toward reducing community hazards to human health. He emphasized that we tend to follow the mandates of adopted laws and regulations when, in fact, more troubling environmental concerns that we have the expertise to identify, should be getting our higher priority. As you might suspect, he is also a strong advocate for risk-based priority setting.

I was particularly intrigued with his comments about visibility, and pointedly asked him if by that he meant more advocacy and/or policy involvement. Not surprisingly, he responded that he felt that the profession had a much greater need to publicize itself and to pursue public relations-type initiatives, saving policy input only for those major issues that are of critical concern to the profession.

To get us where we need to be - which is in a position of authority and respect, he argued that our stage was actually the local community. He commented that that's where the action is, and that's where decisions are made. He eloquently continued that the profession has a responsibility to change how it is perceived, especially at the local level. And that's when he again returned to his opening theme that this is a profession that cannot afford any longer to be invisible.

He stressed that EH programs will live or die depending on local support. In turn, he argued that local support is a function of our visibility and our ability to demonstrate the worth of our work. He said that the media needs to know about us and it needs to promote us and our profession. He commented that we will remain invisible until we get our impressive stories out. Moreover, the longer we remain invisible, the more difficult it will be to gain the support and attention we need - which is the basis for demonstrating what we are truly capable of doing.

Dr. Saunders was a fascinating man to talk to, given the study that he and his colleagues performed. I urge you to read his article, which discusses taking a whole new approach to environmental health problem solving by putting risk assessment of health hazards at the forefront of local priority setting.

He and his colleagues also discuss in the article the need for us to consider changes in our programs that would make us more cost effective and attentive to the community. But above all, and the one comment that you won't find in his paper but you will find in his heart, is that for all the good we do, and for all the good professionals who work in our profession, we aren't going anywhere until we gain greater visibility, particularly in the communities in which we work.

Perhaps not surprisingly, we hear the very same thing in much of our survey work. It has become clear that as your national professional society, the ball is also moving into our court to do more in this area. Public relations and image building - primarily to tell the good story about you - is becoming more of a critical concern, especially in this era of cost cutting and budget reductions. I anticipate that NEHA members will be hearing much more about NEHA's interest in this area in the months ahead.
COPYRIGHT 1996 National Environmental Health Association
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Copyright 1996, Gale Group. All rights reserved. Gale Group is a Thomson Corporation Company.

Article Details
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Title Annotation:the identity crisis of environmental health practitioners
Author:Fabian, Nelson
Publication:Journal of Environmental Health
Article Type:Column
Date:May 1, 1996
Previous Article:Potpourri.
Next Article:Redesigning local environmental health programs.

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