1. Agricultural OH: A New Model for Schools of Public Health Robert McKnight, MPH, ScD Nancy E. Johnson, DrPH, CIH Southeast Center for Agricultural Health & Injury Prevention

2. Southeast Center for Agricultural Health and Injury Prevention NIOSH-funded Within the College of Public Health at the University of Kentucky Exists to fund and direct agricultural health and safety projects.

3. What’s in Kentucky? Horses Horses + Bourbon whiskey + Bourbon whiskey + Tobacco________ AGRICULTURE + Tobacco________ AGRICULTURE University of Kentucky –College of Public Health –Colleges of Agriculture, Medicine, Nursing, Education, Engineering

4. Kentucky Agriculture Kentucky ranks 26 th of 50 states in population (4.1 mil); 4 th in number of farms (88,000) Average <400 acres Horses (#1 US), cattle, corn, broilers, tobacco (#2 US)

5. UK College of Public Health (UK CPH) MPH program prepares professionals for broad-based practice, integrating 5 core disciplines. –Biostatistics –Environmental Health –Epidemiology –Health Behavior –Health Services Management Students take additional courses in 1-2 disciplines for higher development.

6. UK College of Public Health (UK CPH) DrPH degree is an advanced professional practice degree –Mastery of core competencies in the five areas –Advanced specialized knowledge in at least one of the five disciplines. Prepares students as senior-level administrators and policy makers Highest degree attainable for the public health practitioner.

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

8. Older Farmers

9. Pesticides

10. Agricultural Injury - Falls

11. Tractor Overturns

13. Return to Farming with Disability

14. Children in Agriculture

15. The 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).”

16. Agriculture and Public Health In the US, few PH degree programs focus on agriculture; some on rural health. –Occupational safety and health public health students at Iowa, Illinois, and Minnesota Other professionals –MD, RN

17. UK CPH Health of Agricultural Populations (HAP) Program Trans-departmental –Students from any of 5 disciplines 3 course sequence –HAP curriculum Public Health Practicum in an agricultural setting Capstone research in agricultural safety or health. Capstone research in agricultural safety or health.

18. Health of Agricultural Populations Program Biostatistics Epidemiology Health Behavior Health Services Management Occupational & Environmental Health

19. HAP Courses Injury Epidemiology and Control –Teaches and applies Haddon Matrix to agriculture-based case studies. Health of Agricultural Populations –Overview examining intersection of HAP with each discipline & special populations/topics. –Produce research proposal. Advanced Agricultural Health –In-depth re: specific disease & injury. –Includes site visit(s) and assessment(s)

20. Health of Agricultural Populations Final Project Research Proposals MPH, HSM: Outcome measurements for a promotoras program in a Local Health Department MPH, HSM: Spanish radio campaign on tractor safety issues Osteoporosis screening access among Kentucky farmers MPH, EH: Cattle-handling facilities and injury in KY farmers

21. Health of Agricultural Populations Final Project Research Proposals MPH, HB: Focus groups on noise- induced hearing loss in farmers MPH, HB: Farm family education on NAGCATS using electronic communication MPH, EH: Injury rates and risk factors for part-time farmers in a metropolitan county MPH, Epi: Osteoporosis screening access among Kentucky farmers

22. Capstone Research and Graduates Adolescent Pesticide Exposure in Mississippi River Delta, DrPH (2005) Obstructive Lung Disease in Kentucky farmers >age 55, DrPH (2005) Correlates of HIV testing among uninsured Hispanic/Latino women, MPH (2005)

23. Lessons Learned, 2001-2005 Need to increase basic health and safety knowledge for all disciplines. Need to increase studies in conduct and methods of research. Need to fund student studies Cornfield near Nancy, Ky.

24. Occupational Health & Safety Competencies Defined by Council on Linkages Between Academia and Public Health Practice www.trainingfinder.org/competencies/list_levels.htm www.trainingfinder.org/competencies/list_levels.htm Olson, et al (2005) identified cross- cutting OHS competencies for health and safety professionals We want to apply basic cross-cutting OHS competencies across disciplines.

25. MPH Curriculum Plan

26. DrPH Curriculum Plan

27. HAP Program Framework

28. Lessons Learned, 2001-2005 Distance Education –Need better technology for class delivery –NetMeeting© is a new option. –Use success of program and improved delivery to recruit public health and agriculture extension personnel

29. Application to Other Regional Industry Trans-disciplinary cross-cutting OHS competencies. Courses specific to industry health and safety hazards and populations. Research training to facilitate future research-to-practice initatives