This article describes a successful linkage between a school of public health and a local public health department. In setting up a linkage between an academic institution and a local or state practice organization, several questions need to be answered before the details can be worked out. These include: Are there individuals in both organizations with the requisite interests, resources, and motivation ready to form new professional relationships? If appropriate local models of partnering do not exist, what methods, principles, and structures are best suited to the situation at hand? Which student learning opportunities can be incorporated into the project? What funding makes the most sense?
An Unexpected Opportunity
In 1991, these issues were unexpectedly posed for the School of Public Health and Community Medicine at the University of Washington. The precipitating event was the resignation of the Health Officer in Kittitas County, Washington. Before leaving, the health officer suggested to the three elected county commissioners who made up the Board of Health that they might find a replacement at the University of Washington, a two-hour drive away over the mountains. After several discussions and a face-to-face meeting, an agreement was reached whereby the county would serve as a training site for students from the university, paying a fixed amount for their salary and expenses, and the university would provide Health Officer coverage for the county. A stipulation in the agreement permitted either co-signer, with 90 days notice, to terminate the contract, which was to be renewed annually. I was honored to be chosen as the Health Officer and enthusiastically began organizing a program for students from the uni¬versity to contribute their expertise to the county while gaming valuable work experience.
Kittitas County, immediately east of Seattle, stretches southeastward 80 miles from the crest of the Cascade Mountains to the Columbia River. The terrain is forested at the highest elevations, becoming dry grasslands and finally high desert as it slopes to the eastern boundary of the county. Hay is the largest cash crop, and government—local, state, and federal— is the largest employer. Of the 30,000 people living in the county, 15,000 live in Ellensburg, the county seat, which is also the location of Central Washington University. There are four other incorporated towns (the largest of which has a population of 2,000). The remaining population lives in unincorporated parts of the county.
Students as Assistant Health Officers in Kittitas County
One of my first items of business was to arrange for an Assistant Health Officer, a preventive medicine resident usually in the second year of his or her MPH program at the University of Washington, to spend one day a week in Kittitas County. As the Health Officer, I usually make the same trip two or three times a month. We both attend the monthly Board of Health meetings and fulfill other professional obligations as they arise. During the course of their work in the county, the residents have opportunities to fulfill a number of their preventive medicine competency requirements.
These include communicating with the media and the public, using computers for preventive medicine and public health purposes, interpreting laws and regulations relating to the health of a com¬munity, designing and operating a sur¬veillance system, and designing and conducting an outbreak investigation, among others.
The agreement has been successful for both the university and the county. Nine preventive medicine residents have served as Assistant Health Officers for 6 to 12 months from 1991 to 2000. They have brought special expertise in family practice, internal medicine, emergency medicine, obstetrics, and law. All began with a general orientation to the activities of the health department, including accompanying departmental practitioners into the field. Within weeks, the residents identified special areas in which they could make their unique contributions.