The Link: As Surgeon
General, and as a producer and user of research, do you feel there would be value to
developing a coordinated national public health research and applications agenda?
Dr. Satcher: The answer
to this question is not simple. It is certainly timely for the public health
community to identify unanswered questions and areas in which research could provide the
basis for more effective improvement of the health of communities. Limiting
ourselves to a specified agenda of questions, however, might limit the creativity and
contributions available in a less structured approach.
The Link: Is the time
right for bringing together public and private sectors to develop a coordinated public
health research and applications agenda?
Dr. Satcher: As has
become apparent in so many areas, now is absolutely the right time for public, private,
and voluntary sectors of American society to work together on areas of common
concern. The health of the public is one of those areas, and within it, research to
find new answers for the vexing problems we face. We are seeing more and more
collaboration in health services research; I believe that public health systems and
services research would also benefit from more partnerships.
The Link: How might
potential users of research at the community level become involved in identifying
information gaps or establishing research needs?
Dr. Satcher: Potential
users of research at the community level are those who try to implement programs to
improve health of population groups. As they seek guidance for their work, any gap
in information on methods to prevent health problems, or on the effectiveness of those
methods, or on the adaptation of those methods to specific situations, is a potential
research area. Regular communication and collaboration with the nearest academic
public health institution directly or through an association such as a state association
of local health departments would be an appropriate channel for involvement.
The Link: There is a
sense from the public health practice community that much more research exists than is
being used to improve health at the community level. Are you aware of research that
could more effectively be translated and disseminated in a manner to facilitate its
application? What do you think is the best strategy for resolving this disconnect?
Dr. Satcher: The Task
Force on Community Prevention Services is working hard to translate existing knowledge
into a guide for those organizing and providing prevention at the community level.
The minutes of their meetings are full of information on what is known, much of which is
not being put to full use in our communities today.
The Link: As many public
health practitioners believe, do you feel there is an insufficient amount of research
focusing on human behavior? As an area of critical importance to public health, what
means do you perceive for addressing this issue?
Dr. Satcher: Our
culture has often relegated research on behavior to the category 'soft science' and then
left it under-supported and under-developed. It is clear that human behavior at
individual and group levels is a major contributor to health and that much more research
is needed before we fully understand what this means and how we can support healthful,
rather than unhealthful, behavior.
The Link: There
is a well-developed and widely accepted field of health services research. However,
there appears to be no analogous research examining public health services and
systems. Do you feel that there should be more systems-based research that will help
us to determine better ways to carry out the 10 Essential Public Health Services on a
national, state, and community level?
Dr. Satcher: In an ideal
world, health services research would include studies on all types of health services,
including population-focused public health services. I believe that we do need much
more information on exactly how communities can best assure that public health services
are available and functioning well and in partnership with personal care services.
The Link: How should
this initiative be moved forward and funded? Who do you think are the most
appropriate groups to lead the development of a research agenda and how could a long-term
process be established for ensuring that information gaps continue to be identified and
research activities continue to be coordinated?
Dr. Satcher: There is no
quick answer. I am pleased that the Public Health Functions Steering Committee (and
its Working Group) has been taking a serious look at the issue, and I will continue to
follow their dialogue closely. The continuing interest and support of all components
of the public health system will be an important part of any answer. I hope that the
Linkages Council will continue to be a part of the effort.
