Four diseases of disarray in public health.

The Institute of Medicine's report The Future of Public Health stated that "public health is in disarray" (Washington, DC: National Academy Press, 1988). I describe four "diseases" of this disarray: "hardening of the categories," "hypocommitment to training," "tension headache between prevention and treatment," and "cultural incompetence." We must step outside the focus on problems and risk factors to use epidemiology to define health status positively and to identify health enhancing factors. This conference should catalyze innovative, holistic, culturally competent studies that will improve our well-being.