Public Health in the Northwest: Looking at History to Look to the Future

The public health systems of the six Northwest states have frontier roots, and currently cope with a complex mix of old and modern issues. Using examples from specific and diverse communities, the presentation discusses the history of public health systems in six Northwest states (Alaska, Idaho, Montana, Oregon, Washington, and Wyoming), and how that history shapes the present and future of public health systems. This year marks milestones for public health in the region: the 40th anniversary of the University of Washington School of Public Health and the 20th anniversary of the Northwest Center for Public Health Practice. Public health leaders in practice and academic communities of the Northwest have provided reflections and articles about the historical development of public health in this highly diverse region. Some of the articles are collected in the April 2010 issue of the journal Northwest Public Health. The six-state region is 30 percent of the nation's land mass. A large proportion of the counties are rural or frontier, but the region also includes two large metropolitan areas. Stories include: In 1901, the Montana Legislature created the State Board of Health while in the throes of a smallpox epidemic. In the mid-20th century, Alaska Natives experienced the highest incidence of tuberculosis of any group. Communicable diseases remain a concern in Alaska. The public health workforce is about the same size as in 1970, but serves a much larger population. The worforce is more specialized. On the frontier, social factors and community partnerships remain especially important.