AMERICAN JOURNAL OF
Public
Editorials Health January 1976 Volume 66, Number 1
Established 191 1
Change and Challenge face and format of the Journal will take shape with this issue. The cover, more attractive invitation to the inside. The new and enlarged Editorial Board greets you on this page. Editorials, as the observant reader may have noticed last month, will take off from an article, commentary, or public health brief that appears in the current issue. They will contend with it, extend its significance, or follow its content into other pastures, seeking to lure the reader further into the Journal's pages. Thus, they will be solicited and placed as they are in this issue, in contrast to Letters to the Editor which will remain the channel for our readers to express themselves and correct the errors
The
EDITOR Alfred Yankauer, MD, MPH EDITORIAL BOARD Michel A. Ibrahim, MD, PhD (1977) Chairman Faye G. Abdellah, PhD (1977) Rashi Fein, PhD (1978) Ruth B. Galanter, MCP(1977) H. Jack Geiger, MD, MSciHyg (1978) George E. Hardy, Jr., MD, MPH (1978) C. C. Johnson, Jr., MSCE (1977) M. Allen Pond, MPH (1976) Pauline 0. Roberts, MD, MPH (1976) Ruth Roemer, JD (1978) Sam Shapiro (1976) Robert Sigmond (1976) Jeanette J. Simmons, MPH, DSc (1978) David H. Wegman, MD, MSOH (1976) Robert J. Weiss, MD (1977) STAFF William H. McBeath, MD, MPH Executive DirectorlManaging Editor Allen J. Seeber Director of Publications Doyne Bailey Assistant Managing Editor Deborah Watkins Production Editor
AJPH January, 1976, Vol. 66, No. 1
new
we
hope, is a
we
publish.
The Public Health Briefs section will be a continuing feature, designed to provide a home for short original reports of research and evaluation or accounts of projects that are truly creative, as distinct from painfully innovative. Articles themselves we hope to limit to 5,000 words with tables and figures of significance, although exceptional circumstances can bend the limit. All articles will be preceded by abstract on the title page, set up so that it can be reproduced and filed on a 5 x 8 inch index card. The Commentaries section will continue to include viewpoint and polemic. Editorial judgment of suitability for publication will be based upon cogency, clarity, timeliness, and originality rather than the author's point of view. The Journal will exercise its own prerogative of commenting through its editorial pages or through solicitation of accompanying or following commentary.
an
Journal departments will remain-Public Health and The Law appearing monthly and Public Health: Then and Now at least quarterly. Lists of books received will be grouped by subject and published regularly; the handling of book reviews is currently
under discussion with the Editorial Board. A Calendar of Events will be added to the back pages. Official Association matters will continue to receive their due, although the Personals section will be dropped from the Journal, and may be modified somewhat and included in The Nation's Health. So much for the lineaments and appurtenances. Substance is a more important issue. Assuming consistency and expertness in the process of screening and reviewing manuscripts, the quality of a journal's substance depends on the authors of the manuscripts submitted to it. Who are these authors? Insofar as this Editor knows, no professional journal has applied epidemiological principles to itself. This would require the collection and analysis of manuscripts received, their authors, and their fate in the reviewing process. We are collecting such data and will report them when the N seems large enough. Meanwhile, we have some data to report on a biased sample of manuscripts published. Your Editor was curious about the affiliations of the principal author over time. He examined the 1934, 1954 and 1974 volumes. There was relatively little change in job affiliation between 1934 and 1954. In both years, official health agency employees contributed about one-half the published articles-almost equally distributed among federal, state, and local agencies in 1954 but with state and local predominating in 1934. The remaining contributors were equally divided between university facilities and the miscellany we categorize as "all other". In 1974, there was a striking change. Close to two-thirds of the published principal authors were members 15
EDITORIALS
of a university faculty, almost half of them from medical schools-not necessarily all physicians, but almost all affiliated with a Department of Community Medicine, or one with an analogous title. Less than one-quarter of the contributors were affiliated with a health department, and those were mainly from federal and local levels. State health department employees, who had authored 25 per cent of the Journal's articles in 1934, were responsible for only 4 per cent in 1974. Fortuitously, two of the Journal's readers have contributed an analysis of the subject matter of published manuscripts which appears in this issue on page 67. Podell and Keller have analyzed articles published during the two and one-half year period, January, 1973 to June 1975. Their analysis stimulated us to do more digging. We returned to 1934 and 1954, relying upon a less rigorously controlled methodology, but attempting to replicate the Podell/Keller classification scheme. In 1934, 40 per cent of the articles were in the subject area of infectious disease and 20 per cent in the field of environmental health. In 1954, the infectious disease category still accounted for the highest percentage of the articles (23 per cent) and environmental health the second highest (13 per cent). In both years, the broad-ranging category which Podell and Keller have subsumed under the heading Organization of Health Care occupied the third rank order position, 19 per cent in 1934 and 13 per cent in 1954. Obviously, in 1954 there was a proportionately greater spread of articles into other categories: manpower (as apparently defined by Podell and Keller) child health, dental health, and occupational health each accounted for 7-10 per cent of the articles. If we now compare these results with the Podell-Keller analysis, we find that there has been relatively little change in author concern with the Organization of Health Care, which occupied the highest rank order position in 1973-1975, (22 per cent of all published articles). On the other hand, there have been enormous changes in the proportionate distribution of articles with other subject matters. The decline of infectious disease from 40 per cent in 1934 to 7 per cent in 1974, and of environmental sanitation from 20 per cent to 7 and 6 per cent respectively-although, to be precise, there were a few examples of each in the earlier years. Readers will have their own interpretation of these findings but should be warned of hazards along the way. Apart from doubts about classification schemata and validity/reliability criteria, the data sampled were subject to the filtering of a review process which differed over time. They were submitted by different kinds of authors during eras in which the publication outlets for authors were quite dissimilar. Health Laboratory Science, for example, (the quarterly Journal of the Laboratory Section) would be the likely repository today for many contributions formerly included under the heading of Infectious Disease or Environmental Sanitation. In spite of these limitations, the data do seem to say something to us. In their analysis, Podell and Keller had anticipated that Journal articles (independent of its editorials, commentaries, departments, and anti-smoking plugs) would express the concerns of public health professionals. They were disappointed to find that the subjects of Journal articles did not reflect the 16
principle causes of death. Such observations raise questions. Who are public health professionals? Why do some of them submit their manuscripts to this Journal? Journal articles did not reflect the principal causes of death in 1934 and 1954. Why should they do so now? Podell and Keller conclude their paper by suggesting that the contrast between the subjects of Journal articles and the principal causes of death reflects an identity crisis in the public health profession. Perhaps local and state health departments must cope with a severe identity crisis today, but as a "profession" we seem, to this observer, to have been coping with identity crises for the past four decades. These ruminations will doubtless be elaborated upon by others in future pages of the Journal. The real explanation of what appears in its article pages is probably found in the nature and motivation of those who have the time and ability to contribute to it and the publication options they consider when their manuscript has been completed. Motivation and time to write are, in turn, influenced by job affiliation, responsibility, and employer expectation-and by the heavily weighted direction of govemment funding for research and project support. A prevailing practice among many authors is to publish in "specialty" journals in an effort to reach a target audience-a fact which Podell and Keller have not addressed. From these and other hypotheses one could set up other studies of Journal content, and go on perhaps to draw conclusions about the contradictions in our society. All of which brings us back to Journal substance, substance which we hope will not only intrigue its readers but will endure as a contribution to human knowledge and human aspiration. Most of what we publish must be selected from what is contributed. The Journal remains, by and large, a voluntary enterprise. We do not necessarily want more manuscripts-we already process several dozen each fortnight. We do want good manuscripts that deal with all the subject matter subsumed under the many-meaning term "public health" from all the able writers clustered under the public health umbrella-articles which report or address themselves to the public health and social value implications and applications of ongoing research emanating from the biomedical, social, environmental, and other scientific fields pertinent to our society's well-being. Our Journal pages invite, even cry out for, such papers to be written. By the same token, we will continue to reject any papers we feel do not meet our criteria for publication, but will work willingly with authors who have something meaningful, new, and substantive to report.
THE EDITOR Editor's Note: Prospective contributors to the Journal should note some important changes in our instructions to contributors, which are published in the January, April, July, and October issues. For example, we require three copies of each manuscript, a 200-word abstract, and two title pages before processing begins. See page 000 of this issueforfurther details.
AJPH January, 1976, Vol. 66, No. 1
Public
Editorials Health January 1976 Volume 66, Number 1
Established 191 1
Change and Challenge face and format of the Journal will take shape with this issue. The cover, more attractive invitation to the inside. The new and enlarged Editorial Board greets you on this page. Editorials, as the observant reader may have noticed last month, will take off from an article, commentary, or public health brief that appears in the current issue. They will contend with it, extend its significance, or follow its content into other pastures, seeking to lure the reader further into the Journal's pages. Thus, they will be solicited and placed as they are in this issue, in contrast to Letters to the Editor which will remain the channel for our readers to express themselves and correct the errors
The
EDITOR Alfred Yankauer, MD, MPH EDITORIAL BOARD Michel A. Ibrahim, MD, PhD (1977) Chairman Faye G. Abdellah, PhD (1977) Rashi Fein, PhD (1978) Ruth B. Galanter, MCP(1977) H. Jack Geiger, MD, MSciHyg (1978) George E. Hardy, Jr., MD, MPH (1978) C. C. Johnson, Jr., MSCE (1977) M. Allen Pond, MPH (1976) Pauline 0. Roberts, MD, MPH (1976) Ruth Roemer, JD (1978) Sam Shapiro (1976) Robert Sigmond (1976) Jeanette J. Simmons, MPH, DSc (1978) David H. Wegman, MD, MSOH (1976) Robert J. Weiss, MD (1977) STAFF William H. McBeath, MD, MPH Executive DirectorlManaging Editor Allen J. Seeber Director of Publications Doyne Bailey Assistant Managing Editor Deborah Watkins Production Editor
AJPH January, 1976, Vol. 66, No. 1
new
we
hope, is a
we
publish.
The Public Health Briefs section will be a continuing feature, designed to provide a home for short original reports of research and evaluation or accounts of projects that are truly creative, as distinct from painfully innovative. Articles themselves we hope to limit to 5,000 words with tables and figures of significance, although exceptional circumstances can bend the limit. All articles will be preceded by abstract on the title page, set up so that it can be reproduced and filed on a 5 x 8 inch index card. The Commentaries section will continue to include viewpoint and polemic. Editorial judgment of suitability for publication will be based upon cogency, clarity, timeliness, and originality rather than the author's point of view. The Journal will exercise its own prerogative of commenting through its editorial pages or through solicitation of accompanying or following commentary.
an
Journal departments will remain-Public Health and The Law appearing monthly and Public Health: Then and Now at least quarterly. Lists of books received will be grouped by subject and published regularly; the handling of book reviews is currently
under discussion with the Editorial Board. A Calendar of Events will be added to the back pages. Official Association matters will continue to receive their due, although the Personals section will be dropped from the Journal, and may be modified somewhat and included in The Nation's Health. So much for the lineaments and appurtenances. Substance is a more important issue. Assuming consistency and expertness in the process of screening and reviewing manuscripts, the quality of a journal's substance depends on the authors of the manuscripts submitted to it. Who are these authors? Insofar as this Editor knows, no professional journal has applied epidemiological principles to itself. This would require the collection and analysis of manuscripts received, their authors, and their fate in the reviewing process. We are collecting such data and will report them when the N seems large enough. Meanwhile, we have some data to report on a biased sample of manuscripts published. Your Editor was curious about the affiliations of the principal author over time. He examined the 1934, 1954 and 1974 volumes. There was relatively little change in job affiliation between 1934 and 1954. In both years, official health agency employees contributed about one-half the published articles-almost equally distributed among federal, state, and local agencies in 1954 but with state and local predominating in 1934. The remaining contributors were equally divided between university facilities and the miscellany we categorize as "all other". In 1974, there was a striking change. Close to two-thirds of the published principal authors were members 15
EDITORIALS
of a university faculty, almost half of them from medical schools-not necessarily all physicians, but almost all affiliated with a Department of Community Medicine, or one with an analogous title. Less than one-quarter of the contributors were affiliated with a health department, and those were mainly from federal and local levels. State health department employees, who had authored 25 per cent of the Journal's articles in 1934, were responsible for only 4 per cent in 1974. Fortuitously, two of the Journal's readers have contributed an analysis of the subject matter of published manuscripts which appears in this issue on page 67. Podell and Keller have analyzed articles published during the two and one-half year period, January, 1973 to June 1975. Their analysis stimulated us to do more digging. We returned to 1934 and 1954, relying upon a less rigorously controlled methodology, but attempting to replicate the Podell/Keller classification scheme. In 1934, 40 per cent of the articles were in the subject area of infectious disease and 20 per cent in the field of environmental health. In 1954, the infectious disease category still accounted for the highest percentage of the articles (23 per cent) and environmental health the second highest (13 per cent). In both years, the broad-ranging category which Podell and Keller have subsumed under the heading Organization of Health Care occupied the third rank order position, 19 per cent in 1934 and 13 per cent in 1954. Obviously, in 1954 there was a proportionately greater spread of articles into other categories: manpower (as apparently defined by Podell and Keller) child health, dental health, and occupational health each accounted for 7-10 per cent of the articles. If we now compare these results with the Podell-Keller analysis, we find that there has been relatively little change in author concern with the Organization of Health Care, which occupied the highest rank order position in 1973-1975, (22 per cent of all published articles). On the other hand, there have been enormous changes in the proportionate distribution of articles with other subject matters. The decline of infectious disease from 40 per cent in 1934 to 7 per cent in 1974, and of environmental sanitation from 20 per cent to 7 and 6 per cent respectively-although, to be precise, there were a few examples of each in the earlier years. Readers will have their own interpretation of these findings but should be warned of hazards along the way. Apart from doubts about classification schemata and validity/reliability criteria, the data sampled were subject to the filtering of a review process which differed over time. They were submitted by different kinds of authors during eras in which the publication outlets for authors were quite dissimilar. Health Laboratory Science, for example, (the quarterly Journal of the Laboratory Section) would be the likely repository today for many contributions formerly included under the heading of Infectious Disease or Environmental Sanitation. In spite of these limitations, the data do seem to say something to us. In their analysis, Podell and Keller had anticipated that Journal articles (independent of its editorials, commentaries, departments, and anti-smoking plugs) would express the concerns of public health professionals. They were disappointed to find that the subjects of Journal articles did not reflect the 16
principle causes of death. Such observations raise questions. Who are public health professionals? Why do some of them submit their manuscripts to this Journal? Journal articles did not reflect the principal causes of death in 1934 and 1954. Why should they do so now? Podell and Keller conclude their paper by suggesting that the contrast between the subjects of Journal articles and the principal causes of death reflects an identity crisis in the public health profession. Perhaps local and state health departments must cope with a severe identity crisis today, but as a "profession" we seem, to this observer, to have been coping with identity crises for the past four decades. These ruminations will doubtless be elaborated upon by others in future pages of the Journal. The real explanation of what appears in its article pages is probably found in the nature and motivation of those who have the time and ability to contribute to it and the publication options they consider when their manuscript has been completed. Motivation and time to write are, in turn, influenced by job affiliation, responsibility, and employer expectation-and by the heavily weighted direction of govemment funding for research and project support. A prevailing practice among many authors is to publish in "specialty" journals in an effort to reach a target audience-a fact which Podell and Keller have not addressed. From these and other hypotheses one could set up other studies of Journal content, and go on perhaps to draw conclusions about the contradictions in our society. All of which brings us back to Journal substance, substance which we hope will not only intrigue its readers but will endure as a contribution to human knowledge and human aspiration. Most of what we publish must be selected from what is contributed. The Journal remains, by and large, a voluntary enterprise. We do not necessarily want more manuscripts-we already process several dozen each fortnight. We do want good manuscripts that deal with all the subject matter subsumed under the many-meaning term "public health" from all the able writers clustered under the public health umbrella-articles which report or address themselves to the public health and social value implications and applications of ongoing research emanating from the biomedical, social, environmental, and other scientific fields pertinent to our society's well-being. Our Journal pages invite, even cry out for, such papers to be written. By the same token, we will continue to reject any papers we feel do not meet our criteria for publication, but will work willingly with authors who have something meaningful, new, and substantive to report.
THE EDITOR Editor's Note: Prospective contributors to the Journal should note some important changes in our instructions to contributors, which are published in the January, April, July, and October issues. For example, we require three copies of each manuscript, a 200-word abstract, and two title pages before processing begins. See page 000 of this issueforfurther details.
AJPH January, 1976, Vol. 66, No. 1
