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Creating healthier futures: The science behind public health

The Prevention Research Center at Washington University helped expand accessible fitness areas to 1,000 cities in Latin America. (Courtesy photo)

Public health is often the unseen force that keeps our communities thriving. From ensuring clean water to managing vaccination programs and regulating food safety, it is the vital infrastructure that promotes healthier lifestyles and safeguards our environments. Without it, communities are left vulnerable to emerging threats, underscoring the critical need to reinforce this infrastructure.

What makes public health effective is not guesswork. The most successful programs are rooted in research evidence, addressing the unique needs of the populations they serve — whether reducing pollution in a city or tackling health-care access in remote, underserved areas. This is the essence of evidence-based public health (EBPH), which merges scientific findings with the realities of everyday life.

Implementing EBPH is far from simple. It requires not only expertise in research and data collection but also the ability to translate findings into effective solutions. This process is time-consuming and resource-intensive. Further, only 14% of the U.S. public health workforce holds a degree in public health. 

“Particularly in smaller public health agencies, it is common to see people rise up through the ranks, often without formal training in public health,” said Ross C. Brownson, PhD, director of the Prevention Research Center at Washington University in St. Louis. “This points to a significant need for on-the-job training for these individuals to master the skill sets needed to address complex, so-called ‘wicked’ public health challenges.”

This skills gap can lead to reliance on quick fixes or anecdotal evidence, especially under time pressure. 

This raises critical questions: How do we better prepare both students and working professionals to meet the evolving demands of the field? And how do we ensure that the programs implemented are backed by evidence and are truly effective?

Role of prevention research centers

To bridge this gap, Prevention Research Centers (PRCs) have emerged as essential academic hubs partnering with local health departments and community organizations. The Prevention Research Center at WashU was first funded by the U.S. Centers for Disease Control and Prevention (CDC) in 1994. Its goal was to develop and implement evidence-based strategies to reduce health disparities and improve public health outcomes. Today, there are 20 PRCs across the U.S., each addressing unique public health challenges faced by marginalized populations.

Part of the PRC’s mission at WashU centers on implementation science, which studies how to more effectively and quickly apply evidence in real-world practice and policy. WashU is an international leader in implementation science and is home to over 50 implementation scientists. 

Brownson, also the Steven H. and Susan U. Lipstein Distinguished Professor at the Brown School and the School of Medicine and co-director for prevention and control at Siteman Cancer Center, co-authored the seminal book on the subject, “Dissemination and Implementation Research in Health: Translating Science to Practice.” This widely cited 712-page guide, co-written with WashU’s Graham A. Colditz, MD, DrPH, and Enola K. Proctor, PhD, is a key resource for advancing evidence-based public health practices.

The PRC at WashU focuses on prevention strategies for chronic diseases, including cancer, obesity, heart disease and diabetes. Rather than working in isolation, this multidisciplinary team — comprising faculty, staff and students — engages directly with communities, taking a grassroots approach to co-design and implement solutions. 

Amy A. Eyler, PhD, deputy director of the PRC at WashU and a professor at the Brown School, explains how the center’s focus evolved to respond to public health challenges: “As obesity rates surged 20 to 25 years ago, we conducted some of the earliest studies examining how community environments affect physical activity and obesity. Our research revealed, for instance, that the barriers to physical activity vary significantly among women over 40, depending on their race, ethnicity and whether they lived in urban or rural areas.”

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