Public health as a distinct profession: has it arrived?

This article reviews the elements consistent with the definition of a "profession" in the contemporary United States and argues that public health should be considered a distinct profession, recognizing that it has a unique knowledge base and career paths independent of any other occupation or profession. The Welch-Rose Report of 1915 prescribed education for public health professionals and assumed that, although at first the majority of students would be drawn from other professions, such as medicine, nursing, and sanitary engineering, public health was on its way to becoming "a new profession." Nearly a century later, the field of public health has evolved dramatically in the direction predicted. It clearly meets the criteria for being a "profession" in that it has (1) a distinct body of knowledge, (2) an educational credential offered by schools and programs accredited by a specialized accrediting body, (3) career paths that include autonomous practice, and (4) a separate credential, Certified in Public Health (CPH), indicative of self-regulation based on the newly launched examination of the National Board of Public Health Examiners. Barriers remain that challenge independent professional status, including the breadth of the field, more than one accrediting body, wide variation in graduate school curricula, and the newness of the CPH. Nonetheless, the benefits of recognizing public health as a distinct profession are considerable, particularly to the practice and policy communities. These include independence in practice, the ability to recruit the next generation, increased influence on health policy, and infrastructure based on a workforce of strong capacity and leadership capabilities.