Agricultural OH:Agricultural OH: A New Model for A New Model for

Schools of Public HealthSchools of Public Health

Robert McKnight, MPH, ScDRobert McKnight, MPH, ScDNancy E. Johnson, DrPH, CIHNancy E. Johnson, DrPH, CIH

Southeast Center for Southeast Center for Agricultural Health & Injury PreventionAgricultural Health & Injury Prevention

Southeast Center for Agricultural Southeast Center for Agricultural Health and Injury PreventionHealth and Injury Prevention

NIOSH-fundedNIOSH-funded

Within the College of Within the College of Public Health at the Public Health at the University of University of KentuckyKentucky

Exists to fund and Exists to fund and direct agricultural direct agricultural health and safety health and safety projects.projects.

What’s in Kentucky?What’s in Kentucky? Horses Horses

+ Bourbon whiskey+ Bourbon whiskey + Tobacco________ + Tobacco________

AGRICULTUREAGRICULTUREUniversity of KentuckyUniversity of Kentucky– College of Public College of Public

HealthHealth– Colleges of Agriculture, Colleges of Agriculture,

Medicine, Nursing, Medicine, Nursing, Education, EngineeringEducation, Engineering

Kentucky AgricultureKentucky Agriculture

Kentucky ranks 26Kentucky ranks 26thth of 50 states in of 50 states in population (4.1 mil); population (4.1 mil); 44thth in number of in number of farms (88,000)farms (88,000)

Average <400 acresAverage <400 acres

Horses (#1 US), Horses (#1 US), cattle, corn, broilers, cattle, corn, broilers, tobacco (#2 US)tobacco (#2 US)

UK College of Public Health UK College of Public Health (UK CPH)(UK CPH)

MPH program prepares professionals MPH program prepares professionals for broad-based practice, integrating for broad-based practice, integrating 5 core disciplines.5 core disciplines.– BiostatisticsBiostatistics– Environmental HealthEnvironmental Health– EpidemiologyEpidemiology– Health BehaviorHealth Behavior– Health Services ManagementHealth Services Management

Students take additional courses in 1-2 Students take additional courses in 1-2 disciplines for higher development.disciplines for higher development.

UK College of Public Health UK College of Public Health (UK CPH)(UK CPH)

DrPH DrPH degree is an advanced professional degree is an advanced professional practice degree practice degree – Mastery of core competencies in the five Mastery of core competencies in the five

areasareas– Advanced specialized knowledge in at least Advanced specialized knowledge in at least

one of the five disciplines. one of the five disciplines. Prepares students as senior-level administrators Prepares students as senior-level administrators and policy makersand policy makersHighest degree attainable for the public health Highest degree attainable for the public health practitioner.practitioner.

How does agriculture How does agriculture in Kentucky intercept in Kentucky intercept with Public Health?with Public Health?

Older FarmersOlder Farmers

PesticidesPesticides

Agricultural Injury - FallsAgricultural Injury - Falls

Tractor OverturnsTractor Overturns

Return to Farming with Return to Farming with DisabilityDisability

Children in AgricultureChildren in Agriculture

The Public Health SolutionThe Public Health Solution

“Advancing the cause in production agricultural safety and health is best accomplished by recasting the issues of farm hazard and injury prevention and control as public health problems rather than as industrial work problems as they have been traditionally viewed (Murphy 1992).”

Agriculture and Public HealthAgriculture and Public Health

In the US, few PH In the US, few PH degree programs degree programs focus on agriculture; focus on agriculture; some on rural health.some on rural health.– Occupational safety Occupational safety

and healthand health public public health students at health students at Iowa, Illinois, and Iowa, Illinois, and MinnesotaMinnesota

Other professionalsOther professionals– MD, RNMD, RN

UK CPH Health of Agricultural UK CPH Health of Agricultural Populations (HAP) Program Populations (HAP) ProgramTrans-departmentalTrans-departmental– Students from any of 5 Students from any of 5

disciplinesdisciplines3 course sequence 3 course sequence – HAP curriculum HAP curriculum Public Health Practicum Public Health Practicum in an agricultural settingin an agricultural setting Capstone research in Capstone research in agricultural safety or agricultural safety or health.health.

Health of Agricultural Populations

Program

Biostatistics

Epidemiology

Health Behavior

Health Services Management

Occupational & Environmental Health

HAP CoursesHAP Courses

Injury Epidemiology and ControlInjury Epidemiology and Control– Teaches and applies Haddon Matrix to Teaches and applies Haddon Matrix to

agriculture-based case studies.agriculture-based case studies.Health of Agricultural PopulationsHealth of Agricultural Populations– Overview examining intersection of HAP with Overview examining intersection of HAP with

each discipline & special populations/topics.each discipline & special populations/topics.– Produce research proposal.Produce research proposal.Advanced Agricultural HealthAdvanced Agricultural Health– In-depth re: specific disease & injury. In-depth re: specific disease & injury. – Includes site visit(s) and assessment(s)Includes site visit(s) and assessment(s)

Health of Agricultural PopulationsHealth of Agricultural PopulationsFinal Project Research ProposalsFinal Project Research Proposals MPH, HSM: Outcome measurements for a MPH, HSM: Outcome measurements for a promotoraspromotoras program in a Local Health program in a Local Health Department Department MPH, HSM: Spanish radio campaign on MPH, HSM: Spanish radio campaign on tractor safety issues Osteoporosis tractor safety issues Osteoporosis screening access among Kentucky screening access among Kentucky farmers farmers MPH, EH: Cattle-handling facilities and MPH, EH: Cattle-handling facilities and injury in KY farmersinjury in KY farmers

Health of Agricultural PopulationsHealth of Agricultural PopulationsFinal Project Research ProposalsFinal Project Research Proposals

MPH, HB: Focus groups on noise-induced MPH, HB: Focus groups on noise-induced hearing loss in farmers hearing loss in farmers MPH, HB: Farm family education on MPH, HB: Farm family education on NAGCATS using electronic communication NAGCATS using electronic communication MPH, EH: Injury rates and risk factors for MPH, EH: Injury rates and risk factors for part-time farmers in a metropolitan county part-time farmers in a metropolitan county MPH, Epi: MPH, Epi: Osteoporosis screening access Osteoporosis screening access among Kentucky farmersamong Kentucky farmers

Capstone Research and Capstone Research and GraduatesGraduates

Adolescent Pesticide Exposure in Adolescent Pesticide Exposure in Mississippi River Delta, DrPH (2005)Mississippi River Delta, DrPH (2005)

Obstructive Lung Disease in Kentucky Obstructive Lung Disease in Kentucky farmers >age 55, DrPH (2005)farmers >age 55, DrPH (2005)

Correlates of HIV testing among Correlates of HIV testing among uninsured Hispanic/Latino women, MPH uninsured Hispanic/Latino women, MPH (2005)(2005)

Lessons Learned, 2001-2005Lessons Learned, 2001-2005

Need to increase Need to increase basic health and basic health and safety knowledge for safety knowledge for all disciplines.all disciplines.Need to increase Need to increase studies in conduct studies in conduct and methods of and methods of research.research.Need to fund Need to fund student studies student studies Cornfield near Nancy, Ky.

Occupational Health & Safety Occupational Health & Safety CompetenciesCompetencies

Defined by Council on Linkages Defined by Council on Linkages Between Academia and Public Health Between Academia and Public Health PracticePractice www.trainingfinder.org/competencies/list_levels.htmwww.trainingfinder.org/competencies/list_levels.htm

Olson, et al (2005) identified Olson, et al (2005) identified cross-cross-cutting OHS competenciescutting OHS competencies for health for health and safety professionalsand safety professionalsWe want to apply basic cross-cutting We want to apply basic cross-cutting OHS competencies OHS competencies across disciplinesacross disciplines..

MPH Curriculum PlanMPH Curriculum Plan

DrPH Curriculum PlanDrPH Curriculum Plan

HAP Program FrameworkHAP Program Framework

Lessons Learned, 2001-2005Lessons Learned, 2001-2005

Distance EducationDistance Education– Need better technology Need better technology

for class deliveryfor class delivery– NetMeetingNetMeeting© is a new © is a new

option.option.– Use success of Use success of

program and improved program and improved delivery to recruit public delivery to recruit public health and agriculture health and agriculture extension personnelextension personnel

Application to Application to Other Regional IndustryOther Regional Industry

Trans-disciplinary Trans-disciplinary cross-cutting OHS cross-cutting OHS competencies.competencies.Courses specific to Courses specific to industry health and industry health and safety hazards and safety hazards and populations.populations.Research training to Research training to facilitate future facilitate future research-to-practice research-to-practice initativesinitatives