LETTERS TO THE EDITOR
there is little need to debate which one is a more important consideration as both are working toward the same goal: a reduction of excess weight in our population and an increase in the quality of life as a result. Our hope is that as individuals consider the social costs of overweight in addition to health costs, they may well find added motivation to reduce. Timothy G. Lohman, PhD Associate Professor and Nutrition Scientist Physicial Fitness Research Laboratory and Bruce M. Hannon, PhD Associate Professor and Director of the Energy Research Group Center for Advanced Computation University of Illinois Urbana, IL 61801
REFERENCE 1. Abraham S, Carroll MD, Dresser CM and Johnson CL: Dietary Intake Findings. United States, 1971-74. Vital and Health Statistics, Series 11, No. 202, DHEW Publication No. (HRA) 77-1647. Washington, DC, 1977.
The Elitist Syndrome I would like to describe a little recognized public health problem: the Elitism Syndrome, identified as the re-
sult of intense clinical work at the re-
cruiting tables at APHA. The onset of this syndrome occurs
516
at the time of training, in what is considered an elite school of public health (an environmental etiological factor). The novitiate at these schools is provided with role models who focus on broad-based national problems, who have important ties to the federal bureaucracy, and who do much traveling in this country and abroad. Needing the social approval of faculty and new peers, the novitiates soon adopt the attitudes of these role models: only the people at elite schools can do important work; and "theoretical" work is the only meaningful work in which to be involved. After graduation they become dependent on elite schools and their faculty for these social/personal satisfactions. The public health effects of this syndrome include: inadequate numbers of well-trained public health professionals in those locations where the problems occur (and are most likely to be solved); well-trained public health professionals unwilling to attack a particular problem (e.g., sewage) because it has not been recognized by his/her colleagues as a respectable problem. The few well-trained public health professionals who do get to the locus of the problems are unable to cope with nonelitists, frustrated by the lack of appreciation of their expertise, and therefore become motivated to return to the source of the syndrome to seek solace.
To overcome these problems, existing elitist schools might attack the environmental component of the multifactorial etiology by developing networks of field sites, where faculty may be placed to attack local problems and students trained. Sufficient rewards must be established, for serving at these field sites, and skills must be provided these faculty and students for dealing with groups of individuals with whom field projects must be negotiated and further developed. Patterns of federal and state funding may provide the therapeutic fuel to move such a program. The Area Health Education Center (AHEC) concept of the Carnegie Commission and the Bureau of Health Manpower furnishes an initial working model. Perhaps, however, behavioral compliance will pose a problem: schools of public health will not perceive it within their vested interest to develop such community-based programs? Oh well! Maybe faculty at the elitist schools can repress the syndrome by building a program of research on the maldistribution of public health professionals? Tom Baranowski, PhD Director, Division of Consumer Education Assistant Professor, Department of Community Medicine West Virginia University Charleston, WV 25304
AJPH May, 1979, Vol. 69, No. 5
there is little need to debate which one is a more important consideration as both are working toward the same goal: a reduction of excess weight in our population and an increase in the quality of life as a result. Our hope is that as individuals consider the social costs of overweight in addition to health costs, they may well find added motivation to reduce. Timothy G. Lohman, PhD Associate Professor and Nutrition Scientist Physicial Fitness Research Laboratory and Bruce M. Hannon, PhD Associate Professor and Director of the Energy Research Group Center for Advanced Computation University of Illinois Urbana, IL 61801
REFERENCE 1. Abraham S, Carroll MD, Dresser CM and Johnson CL: Dietary Intake Findings. United States, 1971-74. Vital and Health Statistics, Series 11, No. 202, DHEW Publication No. (HRA) 77-1647. Washington, DC, 1977.
The Elitist Syndrome I would like to describe a little recognized public health problem: the Elitism Syndrome, identified as the re-
sult of intense clinical work at the re-
cruiting tables at APHA. The onset of this syndrome occurs
516
at the time of training, in what is considered an elite school of public health (an environmental etiological factor). The novitiate at these schools is provided with role models who focus on broad-based national problems, who have important ties to the federal bureaucracy, and who do much traveling in this country and abroad. Needing the social approval of faculty and new peers, the novitiates soon adopt the attitudes of these role models: only the people at elite schools can do important work; and "theoretical" work is the only meaningful work in which to be involved. After graduation they become dependent on elite schools and their faculty for these social/personal satisfactions. The public health effects of this syndrome include: inadequate numbers of well-trained public health professionals in those locations where the problems occur (and are most likely to be solved); well-trained public health professionals unwilling to attack a particular problem (e.g., sewage) because it has not been recognized by his/her colleagues as a respectable problem. The few well-trained public health professionals who do get to the locus of the problems are unable to cope with nonelitists, frustrated by the lack of appreciation of their expertise, and therefore become motivated to return to the source of the syndrome to seek solace.
To overcome these problems, existing elitist schools might attack the environmental component of the multifactorial etiology by developing networks of field sites, where faculty may be placed to attack local problems and students trained. Sufficient rewards must be established, for serving at these field sites, and skills must be provided these faculty and students for dealing with groups of individuals with whom field projects must be negotiated and further developed. Patterns of federal and state funding may provide the therapeutic fuel to move such a program. The Area Health Education Center (AHEC) concept of the Carnegie Commission and the Bureau of Health Manpower furnishes an initial working model. Perhaps, however, behavioral compliance will pose a problem: schools of public health will not perceive it within their vested interest to develop such community-based programs? Oh well! Maybe faculty at the elitist schools can repress the syndrome by building a program of research on the maldistribution of public health professionals? Tom Baranowski, PhD Director, Division of Consumer Education Assistant Professor, Department of Community Medicine West Virginia University Charleston, WV 25304
AJPH May, 1979, Vol. 69, No. 5
