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Public Health and a Pharmacist's Role
Last weekend, I embarked on a trip to Chapel Hill, North Carolina for orientation for my masters of public health program.

No, no, I'm not changing my career as an inpatient care pharmacist, but it's been a passion of mine for a while to get involved in the field of public health, using it within pharmacy and the community. After taking some policy courses during pharmacy school, at Umich's health management and policy program, I found that I really enjoyed the field of public health. I also noticed that there are very few pharmacists to represent pharmacy within this field.

At orientation, the room encompassed 35 individuals across the country, speaking about their experience in public health. I was astounded by the individuals in the room: compared to only my participation in organizing community health fairs, I had barely anything compared to the experiences that were in the room. There were people who had done amazing work in Rwanda, Africa and so on, NIH Fogarty scholars, people who set up their own non-profit programs to educate individuals on the dangers of HIV/AIDs while living in third world countries for 2-3 years, and so on. And these people were high in their career ladders- managers of companies, well paid lawyers, and so on, who simply had a passion for preventative healthcare and educating where there is a need. I was literally in awe (and half wondered what in the world was I doing compared to these people?).

However, there were only two pharmacists in our group- one being me, and another who was in field outcomes at a pharmaceutical industry. I noticed that in my public health classes as well- I tended to be the only individual even in pharmacy. I once had a presentation in pharmacoeconomics about the cost of antiretroviral drugs in certain countries, and why they should be used, and what were the cost effective and QALYs associated with it- but everyone in my group was from business, law, or medical backgrounds..with none in pharmacy. How ironic- where are the individuals who actually know the mechanism of actions and how the drug works on the body?

And why the lack? A study in the UK recently surveyed the attitudes of pharmacists within community pharmacies and why the lack of involvement. Mostly it was due to time- lack of space,  and lack of demand for it....yet consumers reported that pharmacists never offered them services, so they did not expect to be offered.

There are so many opportunities for us, as pharmacists, to prevent the sick patients we see every day. Obama launched a campaign in April of this year, combatting the abuse of non-prescription medications to be lowered by 15% for prevention of unintentional deaths (as we've seen in the media this past year with deaths of celebrities). The use of counterfeit drugs are a huge problem globally too- according to the World Health Organization, one fifth of global malaria deaths are from fake drugs.  

Even more locally, many states offer an AIDS assistance program for those who are uninsured. Yet, for these programs, due to the lack of recognition and money, there are long wait lists and individuals are thus, not receiving the treatment that they need. Take for instance, Georgia's program-they're applying for a 3 million grant from the CDC to get rid of their waiting list.  But why is there even a wait list? Shouldn't we be going out into the community, teaching as much as possible, preventing individuals to contract this disease?

Yes, we have the knowledge of how medications work, but what are we, as pharmacists, to help the uninsured and those unable to receive the medications that they need? And for those who can afford it, how do we prevent patients from returning to the hospital with worse problems than their previous visit? Even the CDC recognizes that adverse drug events are a major problem as well. So why are we, as pharmacists, not addressing it more strongly, since it is within our field?

Richard Rhodes of Vision of Technology says it best:
"Arguably the greatest technological triumph of the century has been the public-health system, which is sophisticated preventive and investigative medicine organized around mostly low- and medium-tech equipment; ... fully half of us are alive today because of the improvements."

Pharmacy is a constant state of improvement and development- what more can we do in the field of public health?
Created By: Rachael Ng On: Sat, Aug 20, 2011 03:56 AM

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Lindsey Childs August 25, 2011 6:22 am
I got my MPH before starting pharmacy school, and I believe it to be a very worthwhile educational experience for ALL health care professionals. My public health concentration with in global health and clinical epidemiology, so I was fortunate to learn about health education in Germany (while in Cologne for a week) and work with a non-profit in the Dominican Republic that runs one of only two domestic violence shelters in the entire country. Definitely life-changing experiences.
Thanks for posting!
Jeffrey Little August 23, 2011 11:29 am
I pursued my Masters of Public Health a few years ago and found it to be a fantastic educational experience. I would highly recommend it. Here is a policy statement from the American Public Health Association on this topic: http://www.apha.org/advocacy/policy/policysearch/default.htm?id=1338
Kimberly Flynn August 21, 2011 11:22 am
I have been thinking about pursuing this same degree and have spent the weekend researching it. Logged on to AHSP website and saw your blog post as the top one! Thanks for sharing!
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