Abstract
Since its founding in 1950, the Society for Public Health Education (SOPHE) has evolved in response to the changing needs of both the public and the profession. This SOPHE Presidential Address provides a brief review of SOPHE’s history and the legacy of its achievements over some 60 years. It also describes how new challenges being created by the pending organizational realignment between SOPHE and the American Association for Health Education, which promises to further unify the profession, along with changing American community demographics, can provide an opportunity for SOPHE to strengthen the health education profession by becoming more inclusive and further redefining Dorothy Nyswander’s concept of the “Open Society” and the role health educators play as agents of change.
Keywords
I
I want to welcome all of you to the 62nd Annual Meeting of the Society for Public Health Education. I know that annual meeting trustee Eva Doyle and the conference planning committee have been working tirelessly to organize an outstanding meeting. Their efforts have been supported by the Society for Public Health Education (SOPHE) Board of Trustees and especially by our CEO, Elaine Auld, and the SOPHE staff. I also want to thank our SOPHE conference supporters, including the Centers for Disease Control and Prevention, the James F. and Sarah T. Fries Foundation, Sage Publications, and the National Capital Area SOPHE Chapter. Thank you for your efforts on behalf of what I am confident will be one of SOPHE’s most outstanding annual meetings.
I also thank my wonderful San Jose State University friends, colleagues, and students. In particular, my colleague and friend, Kathleen Roe, with whom I have worked over the past 22 years, along with our colleagues, Ed Mamary and Anne Demers, to carry on Helen Ross’s legacy of excellence in our health education MPH program; and my friends, Frank Strona and Robert Rink, who have inspired me to take on the issue of LGBT inclusiveness in SOPHE. All of them have been encouraging, thoughtful, supportive, illuminating, and, of course, if you have seen us together in our offices, or at SOPHE meetings, very funny. We truly believe, as E.E. Cummings wrote, “The most wasted of all days is one without laughter” (Cummings, n.d.).
Finally, I want to thank my family, especially my wife, Denise, for her constant support during my SOPHE presidency.
II
As any person who has ever served in a position of leadership knows what you plan to accomplish and what you actually accomplish can be affected by unexpected events and challenges. Indeed, it is how you address those challenges that can determine the failure or success of your leadership.
Last year, I stood before you and told you that my most important initiative would be to increase the inclusiveness our LGBT members in SOPHE. I also talked about increasing the involvement of students and Latino SOPHE members in SOPHE leadership roles. We have made progress across each of these initiatives through the implementation of our new strategic plan and through our process of gathering information from SOPHE chapters and national members on LGBT inclusiveness, an effort that will help shape recommendations on which I hope to act as SOPHE Past President.
I was elected SOPHE President-Elect in the summer of 2009 and quickly learned from then SOPHE President Kathy Meier that the SOPHE Executive Committee and Board of Trustees had been having exchanges with the leadership of the American Association for Health Education (AAHE), in response to queries from AAHE about creating a new organization that could unify the health education profession. Over the past 2 years, this has become a focal point of my SOPHE leadership, the SOPHE Executive Committee, the Board of Trustees, and a special task force consisting of SOPHE and AAHE leaders that has worked on what we dubbed the “modified merger.” 1
Simultaneously, I also began to realize that our discussions with AAHE had significant implications for SOPHE’s inclusiveness of health educators coming from AAHE. However, as I view what has occurred over the past 2 years, during our discussions with AAHE, and envision how these discussions will unfold, I cannot help but reflect on the history of SOPHE and how a modified merger may shape our organization going forward. Thus, I began to reflect on what SOPHE has been, what SOPHE is now, and what SOPHE can be in the future.
Drawing on the research of previous SOPHE historians, including Flora Bloom (1999) and William Cissell (1976), I want first to highlight some of the major events in SOPHE’s more than 60-year history by drawing some contrasts between the SOPHE of the early decades since our founding and the SOPHE of today. My main purpose, however, is to show how new challenges being created by the pending organizational realignment between SOPHE and AAHE, which could further unify the profession, along with changing American community demographics, can provide an opportunity for SOPHE to strengthen the health education profession by expanding our membership and embracing an even broader diversity of members, thus further redefining Dorothy Nyswander’s concept of the “Open Society” and our role as change agents.
III
What we now call the Society for Public Health Education, or affectionately, SOPHE, began in St. Louis, Missouri, at a 1950 meeting of approximately 25 health educators (SOPHE, n.d.). It was called the Society of Public Health Educators and not the Society for Public Health Education as we are known today. Annual dues were $5.
The 1950s
When SOPHE was formed in 1950, its Constitution restricted membership to “A person who has a graduate degree from a school accredited by the American Public Health Association (APHA) plus at least two years of professional (health education) experience.” (It may seem strange to hear that APHA was the public health credentialing body, but APHA served as the accrediting body for schools of public health and MPH programs in community health education until the Council on Education for Public Health [CEPH] was formally established in 1973.) So, in effect, if you had a bachelor’s degree in health education, or if your undergraduate or graduate degree was not in health education, you could not be a member of SOPHE. It is important to note here that during this period there were only a limited number of schools of public health and graduate programs in community health education. In effect, SOPHE membership was thus restricted, both by definition and by the small number of institutions awarding graduate degrees. Today, there are 131 accredited institutions—48 schools of public health and 83 public health programs accredited by CEPH. There are an additional four schools of public health and 30 master of public health programs in the CEPH accreditation pipeline (Council on Education for Public Health, 2011). Furthermore, the total number of accredited schools of public health and public health programs will potentially increase from 131 to 165, in just the next 2 years. When you include the many other institutions offering health education degrees, such as those recognized by the SOPHE/AAHE Baccalaureate Approval Committee (SABPAC) or the Council for the Accreditation of Educator Preparation (CAEP), one quickly sees that opportunity for growth abounds for SOPHE, for the field of health education, and for public health, in general.
By the end of the 1950s, a SOPHE Publication Committee had developed its first health education newsletter, which was a brief mimeographed paper. Later, in 1957, SOPHE published its first issue of the Health Education Monographs series, which then evolved into Health Education Quarterly and then again later into Health Education & Behavior, as it is now known, one of the most prestigious public health journals in the world. By 1959, membership grew to 327 members and dues had increased to $7.50 per year. During these years, SOPHE formed affiliations and aligned itself with other organizations, most notably the International Union for Health Promotion and Education (IUHPE) and the National Health Council.
The 1960s
Starting in 1961, SOPHE began expanding its membership and changed its bylaws to eliminate the 2 years of experience requirement for persons with graduate degrees from schools of public health. Individuals with a graduate degree that had been earned in a school other than a school of public health were required to have a minimum of 3 years of health education experience to becoming members. Those with a bachelor’s degree were required to have 5 years of experience.
SOPHE also established a central office in New York City. Subsequently, in the 1970s, the office moved to Berkeley, California, under volunteer executive director Jim Lovegren. It remained there until 1995 when, through the combined efforts of Noreen Clark and Paul Mico, and other leaders, a contract was negotiated with Sage Publications that provided the basic resources to move the society to Washington, D.C., a move long advocated by SOPHE leaders such as Larry Green and John Allegrante. They, and others, believed it was important for the organization to be at the heart of America’s policy making center, in order to advocate for the health education profession. Elaine Auld was hired as the Executive Director to make it all happen.
Contrasting the SOPHE of the 1960s with the SOPHE of today, one can only marvel at how the organization has evolved. In the 1960s, SOPHE
Recognized seven regional chapters. Today SOPHE has 19 chapters that cover more than 30 states, northern Mexico, and Western Canada.
Passed a resolution to participate in a School Health Education Study, the first of many school health education activities for SOPHE.
Established the Honorary Fellow Award and presented the award to pioneer health educators, including Sally Lucas Jean, Dorothy Nyswander, and Clair Turner. Tomorrow, honorary awards will be bestowed to First Lady Michelle Obama for leading the nation’s “Let’s Move” program and to Dr. James Prochaska, internationally recognized for the Transtheoretical Model of the Stages of Change.
Increased membership from only 327 in 1959 to 550 in 1970. Today, we have a combined chapter and National SOPHE membership of approximately 3,700 members.
Managed a budget of $11,000 in 1965. Today, our budget is approximately $2 million.
In 1969, the SOPHE Board of Trustees approved the change from the Society of Public Health Educators to its present-day name of the Society for Public Health Education. The board also promoted the important concept that “SOPHE is devoted primarily to service for the benefit of the public rather than just for the membership or the profession.” I believe that this was a milestone public statement. But, as a person who grew up in South Florida during segregation and Jim Crow law, I also believe that this statement reflected the impact of the civil rights movement and the resulting common-sense thinking of SOPHE leaders whose philosophical foundation was grounded in social justice.
Probably no member reflected this better than Dorothy Nyswander, who, in her 1966 landmark lecture, “The Open Society: Its Implication for Health Educators” (Nyswander, 1967), which she gave at Berkeley, California, laid out the principles that have served as a foundation of SOPHE ever since. As my friend and colleague, SOPHE Past President Kathleen Roe so eloquently noted during her own presidential address in Boston in November 2000, Dorothy imagined that an open society would comprise dreamers and activists, in which diversity is celebrated, and dissent, disagreement, and the vigorous exchange of ideas are necessary for growth and possibility; a society in which our dreams and values and deepest commitments are realized in our daily actions, and no one is left behind (Roe, 2000).
The 1970s to the 2000s
SOPHE’s concern with defining membership, among other issues, would continue into the 1970s and beyond. The Board of Trustees decided to drop the criterion for potential members to be engaged in community health education. They reduced the full-time experience requirement for those with a graduate degree, but not from a school of public health, from 3 years to 1 year, and from 5 years to 3 years for those with a bachelor’s degree. Combined with active recruitment, membership grew from 550 in 1970 to nearly 1,200 in 1975.
SOPHE honored many pioneers with the Honorary Fellow Award during the 1970s, including the health educator Vivian Drenckhahn. Because of the generosity of her endowed donation of $100,000 in 1998 to SOPHE’s first capital campaign, her legacy to SOPHE and to the field of health education continues today in the form of the SOPHE Vivian Drenckhahn Scholarship Award. This award provides $3,000 to support two full-time undergraduate and/or graduate-level students ($1,500 each) in their educational and professional development and excellence in health education. Vivian, and others, began what SOPHE Past President John Allegrante would later describe as “a culture of giving” that he launched during his presidency (J. P. Allegrante, personal communication, 2011). Today, SOPHE has nearly $1.4 million in resources that include investments, scholarship funds, and the SOPHE “Campaign for the 21st Century: Building SOPHE’s Future” fund. It is important to note that in 2010, 70% of SOPHE donations came from individuals like those in this audience.
The 1970s also saw the development of the SOPHE News and Views newsletter, which was mailed to members, whereas today four issues are sent electronically to all SOPHE members, while two are mailed. In 1975, SOPHE Past Presidents Larry Green and Sigrid Deeds were appointed editors of Health Education Monographs and increased the focus on publishing articles on research-to-practice. Today, both Health Education & Behavior and Health Promotion Practice reflect Larry and Sigrid’s enduring legacies.
In 1976, the SOPHE Northern California chapter created a task force to develop the first health education profession Code of Ethics. The task force was chaired by Elizabeth Bernheimer and included Paul Mico. The Code of Ethics was revised in 1983 and again in 1992. Subsequently, in collaboration with AAHE and other members of the Coalition of National Health Education Organizations (CNHEO), a Unified Code of Ethics was approved in 1999 (Coalition of National Health Education Organizations, 1999) and updated again in early 2011.
Also in 1976, under a task force chaired by Helen Ross, guidelines for the preparation and practice of professional health educators were developed. This led to a 1978 meeting in which SOPHE President Helen Ross and representatives from the CNHEO began to identify the role of health educators. In collaboration with the National Center for Health Education, this 3-year effort became known as the Role Delineation Project (Henderson & McIntosh, 1981; Henderson, Wolle, Cortese, & McIntosh, 1981). The role of the entry-level health education specialist was defined during the years 1978 to 1981 and became the basis for the CHES credentialing process. This was followed in the early 2000s by the Task Force on Accreditation in Health Education (Allegrante et al., 2004; Cottrell et al., 2009) and the subsequent Competencies Update Project (Airhihenbuwa et al., 2005; Gilmore, Olsen, Taub, & Connell, 2005)—both supported by SOPHE and AAHE—which established a framework for a unified system for professional preparation in health education and redefined entry-level and defined advanced-level competencies for the field. These profession-wide efforts have since led to the new Master Certified Health Education Specialist (MCHES) designation and helped catalyze emerging interest in the accreditation of undergraduate public health programs.
In his 1998 SOPHE Presidential Address, John Allegrante highlighted the tremendous changes that occurred within SOPHE during the 21-year period between 1977 and 1998 (Allegrante, 1999). Let me just highlight some of the most important achievements noted by John.
The field of health education firmed up its science base and demonstrated the power of health education to influence health status.
The occupation of Health Educator was given a distinct occupational classification by the U.S. Departments of Labor and Commerce.
Health educator Audrey Gotsch was about to assume the presidency of the American Public Health Association, the first health educator ever to be elected president.
We established a public health education leadership institute in collaboration with the Association of State and Territorial Directors of Health Promotion and Public Health Education (ASTHPPHE, now known as the Directors of Health Promotion and Education [DHPE]).
And on that day, John announced that the first of its kind peer-reviewed journal dedicated to practice, Health Promotion Practice, would be launched by SOPHE in 1999 and the first volume to be published in 2000.
John also cautioned us to remain cognizant of upcoming trends and the implications of those trends for the field of health education. He recognized that we exist in a global community with health issues such as tobacco cutting across international boundaries and spoke of the importance of protecting the “public commons.” Today, nearly 15 years after John’s prescient address, obesity is becoming a worldwide crisis and has, along with physical inactivity, effectively become one of the leading causes of preventable death. Clearly, health educators in community settings and in schools have a role in helping to stem this tide.
He also noted the impending explosion of the World Wide Web and its potential effect on our concept of communication. But this was before electronic media and tools such as Steven Job’s iPhone and the iPad; and before YouTube and other social media such as Facebook and Twitter. Indeed, CDC was an active user of Twitter to keep public health departments informed during the H1N1 outbreak, in 2009. Today, SOPHE has adopted and used many of these new communication tools, including webinars that reached 1,000 people in 2011.
Finally, SOPHE has recently expanded its global impact by collaborating with IUHPE. One example of this was the 2008 Galway Consensus Conference (Allegrante, Barry, Auld, Lamarre, & Taub, 2009), which sought to identify domains of core competencies (Allegrante, Barry, Airhihenbuwa, et al., 2009) that have provided the basis for conversations about global health education practice and subsequent efforts to define areas of competency that are now being adopted in Europe and in other parts of the world.
We have achieved a lot in the past 60 years. Our achievements, in collaboration with our health education allies, such as AAHE and other groups, have had an effect on national health education credentialing, research, practice, curriculum, publications, and progress in eliminating health disparities. But I believe that these achievements are a result of an acknowledgment among SOPHE members that SOPHE is devoted primarily to service for the benefit of the public rather than just for the membership or the profession.
Toward that end, in 2010, the Board of Trustees approved and began to implement a new strategic plan. The plan, which is available at the SOPHE website (SOPHE, 2010), was developed by a 20-member planning committee, spread across four workgroups, that was cochaired by SOPHE President-Elect Robert Gold and Past President Kathy Meier. In my more than 20 years as a SOPHE member, I have never seen a plan that was so ambitious—and I mean that in a very positive way.
The plan has two goals. In Goal 1, SOPHE will be the “Authoritative source for health education and health promotion.” It has four priority areas: (1) professional development, (2) health education advocacy capacity building, (3) advocacy for policy issues, and (4) advocacy for the profession. Across this goal, there are 31 objectives and 20 strategies. In Goal 2, which is to “Optimize SOPHE’s organizational performance,” the six priority areas are the following: (1) advance research in the field; (2) promote the adoption of evidenced-based practice; (3) create leadership opportunities for staff and volunteers; (4) expand SOPHE’s public relations, marketing, and communication; (5) monitor and evaluate organizational performance; and (6) ensure sustainable resources. Across Goal 2, there are 31 objectives and 20 strategies. Each goal’s objectives are spread across a 5-year period and every single one of those 61 objectives and 40 strategies must be implemented, measured, and documented.
IV
As I hope you can see from my overview of our history, SOPHE has reevaluated its definition of membership many times. In that respect, it can be said that the SOPHE leaders have kept an open mind as the world has changed around them. We have evolved from a time 60 years ago when a SOPHE member was required to hold a graduate degree in public health. Today, anyone who believes that he/she identifies with SOPHE’s purpose is welcome to join. Indeed, let me quote from the latest SOPHE bylaws on what constitutes a SOPHE member:
An Individual Member shall be a public health educator who is a professional with a graduate or undergraduate degree from a formal public health education, or a related program; a professional who is employed or is functioning in a public health education capacity; a faculty member of a public health education program; a student in a public health education program; a retired public health educator; and/or anyone with an interest in public health education. (SOPHE, 2008)
This sounds very inclusive. But is it enough?
Over the past 3 years we have been having serious discussions with the AAHE leadership on aligning the two organizations. AAHE has been part of the American Alliance for Health, Physical Education, Recreation, and Dance (AAHPERD) for many years. Many of the AAHE members identify themselves as health educators. Indeed, within the SOPHE leadership Past Presidents Collins Airhihenbuwa and Diane Allensworth, and our incoming President Bob Gold and our new President-Elect, Kelli McCormack Brown, have all served in AAHE leadership roles during their careers. However, this is not the first time that SOPHE and AAHE have discussed unification. In the mid-1980s, SOPHE President Larry Green and AAHE President Peter Cortese led a task force in an effort to combine both organizations. This effort went on for almost 10 years before both organizations concluded that, as Larry Green told me recently, “the time was not right” (Lawrence Green, personal communication, 2011).
So, where are we today in terms of SOPHE and AAHE? Is the time now right? Nearly 2 years ago, AAHPERD concluded that it should reorganize to focus on the field of physical education and health. AAHPERD informed the AAHE leadership that they were free to begin discussions with SOPHE in what was at that time described as the unification of the health education profession. Personally, I do not believe that SOPHE and AAHE coming together will unify the health education profession entirely, as there are other health education organizations that will continue to exist. However, a modified merger of SOPHE and AAHE could certainly further strengthen the health education profession and allow us to speak in a louder voice on behalf of the public on matters related to the population’s health.
Over the past 2 years, we held numerous telephone conferences and documented exchanges that culminated in a face-to-face meeting in July 2011 at the University of Maryland School of Public Health. The meeting was hosted by SOPHE President-Elect, and school dean, Bob Gold, and facilitated by Kathleen Miner of Emory University. From this meeting of 14 SOPHE and AAHE representatives, a framework for future discussion emerged. In September of this year, the AAHPERD Board of Governors made a critically important decision when they voted formally and unanimously to approve the separation of AAHE from AAHPERD. This process will take approximately 18 more months to complete and is expected to culminate in a final legal separation in May of 2013. However, between now and then SOPHE and AAHE leaders will continue their discussions and due diligence, under the July 2011 framework, to address how best to incorporate AAHE’s journals and its legacy of awards and scholarships into an expanded SOPHE organization.
I believe that we will be able to sort these things out; however, I also believe that an important issue will be the inclusion of AAHE members, many of whom identify themselves as school health educators, and may not feel they have a home in an organization that is perceived by some as strictly public health education. My own feeling is that we are all interested in improving the health of the public, whether it is in the broad context of community health settings or the more specific context of the local elementary schools. In addition, school health education is not new to SOPHE; we have long had funded initiatives, special interest groups, and now communities of practice in the area of school health education.
V
In 1991, about a year after I arrived to teach at San Jose State University, Kathleen Roe was serving as Northern California SOPHE Chapter President and chaired a planning committee for the chapter’s annual conference. One of the things I remember most about that conference was that Kathy showed a videotape recording of health education pioneer Dorothy Nyswander talking about what it really meant to be a health educator. I believe Dorothy was about 95 years old at the time. She talked about the very early days of the health education profession, but the most important thing that I took away from seeing the video was what Dorothy said, “Above all, health educators are agents of change.” Think about what Dorothy said and what it means to be “an agent of change.”
My Presidential Address is a call to action. I believe you can be an agent of change and help SOPHE to meet its challenges and achieve new heights in this second decade of the 21st century and the decades that will follow. I am confident that many of you will be lifelong SOPHE members, like so many who came before you. So, how can you be an agent of change? You can do it by helping us to broaden the Open Society that is SOPHE. There are three ways you can do this.
First, Diane Allensworth, Bob Gold, and Rick Cain have been in the process of assigning responsibilities for implementation and tracking of the objectives associated with SOPHE’s 2011-2016 strategic plan. Much of this work will fall on SOPHE’s trustees and executive committee; however, it has become apparent to the SOPHE leadership that we will need your help. I am confident that across those two goals, 10 priority areas, 61 objectives, and 40 strategies, that there is not a single person in this room who could not find an objective or strategy where his/her knowledge or skills could be applied. So I urge you to offer your assistance to SOPHE leaders as we continue to implement this landmark strategic plan.
Second, over the next 18 months and beyond, we will be seeking ways to welcome AAHE members into the SOPHE family. We need your ideas for outreach, but most of all we need your assistance in helping those health educators, when they do decide to join SOPHE and attend your chapter meetings and the National SOPHE Annual Meeting, to feel welcomed. We all know what it is like to walk into a strange home and be greeted by a smiling face and a welcoming hand—it makes all the difference in feeling included.
Finally, as I noted earlier, discussions of inclusion are not new to SOPHE. For example, as pointed out by Kathleen Roe in her 2000 SOPHE Presidential Address, the SOPHE Board approved a resolution on multiculturalism, drafted by Stephen Thomas in 1991 to ensure the inclusion of gender, race, sexual orientation, disabilities, and social class issues in SOPHE conferences and publications. This also challenged SOPHE to provide leadership to include diversity in chapter and national governance. In 2000, Kathleen Roe established the Open Society Commission and during the 2000 SOPHE Annual Meeting in Boston, the SOPHE Board approved a resolution to take specific action to eliminate health disparities associated with race and ethnicity in the United States. During the subsequent midyear meeting in 2001, Rebecca Reeve and other members of the Open Society Commission drafted a resolution to eliminate health disparities associated with sexual orientation, which was then approved by the SOPHE Board. So we have been down this road before. But I think it is time that we recommit to the principles of inclusion established by Stephen, Kathleen, and others.
Last year, I created an LGBT Task Force, cochaired by Frank Strona and Robert Rinck, to explore ways that we can increase the inclusion of our LGBT members. Over the year, the task force has gathered data from nearly 200 SOPHE members on their opinions of the inclusiveness of LGBT individuals in SOPHE chapters and National SOPHE. Some of this information was presented at the SOPHE 2011 midyear meeting in Albuquerque. Although I firmly believe that SOPHE members have a welcoming and inclusive heart, we have learned that the great majority of SOPHE members are unsure about their chapter’s or National SOPHE’s level of inclusiveness of LGBT members, whether it was inclusive language in the mission statement, having a chapter LGBT Committee, or whether their chapter had trainings or programming that reflected content with LGBT themes. I was a bit surprised with the uncertainty because I know that we are not a profession that is comfortable with uncertainty about important issues. But I would like for you to join us as agents of change in this regard. I would like to see SOPHE become an organization where no gay, no lesbian, no bisexual, or no transgender person ever says to me again, as a friend did recently: “I was a member of SOPHE for year in 2008, but as a gay man, I have never felt welcomed.”
VI
I am very proud to be a SOPHE member and very honored to have served as your President over the past year. However, I recognize that SOPHE is only as good as its members are active. In my upcoming role as SOPHE Past President, I hope to emulate the many past presidents, and countless SOPHE members, who served and then continued to play key roles in raising SOPHE’s prominence in the field of health education and in advancing the agenda of our field in areas such as credentialing and health disparities. But above all, it has been their willingness to “speak truth to power” through the electronic and print media, the halls of Congress, and even in the streets of America, that has added value to SOPHE’s capacity as an agent of change. And the primary reason that I will stay involved is because, like you, I too want to continue to be that agent of change we need.