The role of universities in personal health improvement

Abstract There is rapidly growing evidence that much chronic disease incidence is related to individuals' patterns of living and their life-styles. Considerable evidence also suggests that the key to preventing or moderating the occurrence of chronic disease lies in moderating or adapting unhealthy life-styles and health habits. Universities have not been in the forefront of this important new area and have been surpassed by the general public and by others in the nonacademic community. There is still an important leadership role for universities to play, however, and indeed, there are some presently unfilled roles that only universities can fill. To exert the influence and leadership that they should in this field, universities will have to reexamine their present priorities and procedures, and chart new directions where necessary. Most likely, universities will have to develop entirely new “laboratories” in parallel with the university teaching hospitals, so that health promotion research can be carried out in an adequate setting. Programs of education and training in health sciences will have to be redesigned, not only to ensure that students understand the origins and development of chronic diseases, but also to ensure that they are confronted with their own susceptibility to such conditions and the steps they need to take to reduce their own personal risk. Universities need to review their allocation of financial and personnel resources for medical resident education to ensure distribution of specialist graduates that is more directly in line with the future projected needs of our country for physicians of all kinds. Finally, universities must begin to appreciate that they are also major employers to personnel and that they have an obligation and an unparalleled opportunity to develop new and innovative approaches to health promotion at the worksite. To exert the needed influence and leadership, universities will also have to come to grips with certain major obstacles in the typical university organizational form and the typical faculty reward system. With regard to university structure, it has been pointed out that research and demonstration projects in chronic disease prevention and life-style change must be multidisciplinary, involving a wide variety of faculty resources and skills; the issues and problems involved are simply too diverse and detailed to be handled by any one discipline. Universities, however, organized as they are into single-discipline departments, have had a great deal of difficulty in mounting major long-term interdisciplinary research projects and demonstrations in an effective fashion. Short-term projects and projects involving two or, at the most, three different disciplines are occasionally carried out, but major long-term projects that require a serious commitment from many departments have a serious problem. With regard to the typical university reward structure: in the past, universities have put great emphasis on individual contributions, work in which one person is clearly responsible for the results, if any occur; they have not been quick to reward team efforts in which a number of persons are equally (and sometimes indistinguishably) responsible for the results. In the same fashion, universities have not been quick to reward faculty who involve themselves in organization—or team—building, or who take on the thankless administrative tasks of managing organizations or keeping interdisciplinary teams or networks functioning effectively. Since much of the, task ahead for universities, in the area of chronic disease prevention and life-style laboratories, will involve the organizing and managing of new life-style laboratories, which will-involve the development and maintenance of broad interdisciplinary networks and teams, universities will have to change the basis on which they reward their faculty for their efforts. It is said that this country is entering a new era of disease control and improved health of its people. Universities have an important role to play in that new era but in order to play that role a good bit of thought and a considerable will to change must come about.