As the nation moves toward meeting the goals and objectives for Healthy People 2010, so do the states, regions and individuals living in each community. Indeed, the underlying premise of Healthy People 2010 is that the health of the individual is almost inseparable from the health of the larger community and that the health of every community in every state and territory determines the overall health status of the nation.

Although the United States as a nation has already set up two overall goals for year 2010 (a. Increase quality and year of healthy life; and b. Eliminate health disparities) and over 400 specific objectives, several states are still working on their priority goals and objectives. Regardless, based on the epidemiological data, most states including Maine are working on the leading killers and the sources of disabilities. Three quarters of Maine people die from only four diseases: cardiovascular diseases, cancer, chronic lung disease and diabetes. These four diseases also cause over one third of all disabilities.

Examining the risk factors for these health conditions, it is evident that personal health behavior is on the top of the list. It makes preventive strategy one of the keys to reduce the majority of chronic conditions.

Knowledge about the prevention of these diseases is crucial. Moreover, skills to maintain healthy behavior are even more important. Studies have shown that the level of knowledge does not predict the behavior modification. Therefore, it is important not only to educate the public about the importance of prevention but also equip them with the appropriate skills to change their behaviors. Therefore, the issue is not just about education but about effective education. Again it is not just about effective education but effective education in health.

The question remains, who is going to concentrate on the preventive part of health care? As we gain more knowledge about the relationship between health, disease and health behavior, it is obvious that the writers, journalists, social workers, visiting nurses, physicians, dentists (primary caregivers) are unable to provide the needed health education. Most clinical practitioners and mental health counselors are barely meeting the needs for the clinical portion of health care, especially in rural areas where health care providers are overburdened with their primary jobs.

Based upon the need to provide the public with good health information, the role of the health educator in the United States has evolved over time. A health educator has to be somebody who knows how to educate people effectively and more importantly knows how to persuade people to change their behaviors. Today the discipline of health education has progressed and modified its role significantly. It is producing entry-level health educators who can work in a variety of settings including schools (K-12, colleges and universities), community health agencies, worksites (business, industry, other work settings), and medical settings (clinics, hospitals, HMOs).

The role has expanded over the years so that health educators are now covering all aspects of health promotion. The roles are defined based on the competency-based framework for professional development of Certified Health Education Specialists (CHES). A national CHES certification ensures that the health educator can perform the seven most important responsibilities of health education. These are: assessing individual and community needs for health education, planning effective health education programs, implementing health education programs, evaluating the effectiveness of health education programs, coordinating provision of health education services, acting as a resource person in health education, and communicating health and health education needs, concerns, and resources.

Nationwide, there are more than 100 health education programs producing health educators for a variety of settings. The state of Maine has only two health education programs, one in Farmington and one at the University of Maine at Presque Isle. Both departments have school health as well as community health track degree programs.

Once students get a BS degree in health education they are qualified to get CHES certification, a national license for health educators. Students can take entry-level health education positions with mid 20s starting salary or they can pursue a master’s degree in any public health field.

The presence of professional health educators is critical if the community wants to work on a health agenda and focus on the prevention aspect of health care. As the tobacco settlement money is allocated for several aspects of health education in Maine, more and more communities will be in need of professional health educators. In order to make the CHES certification easily accessible, UMPI has offered to be a testing site for the certification exam. In the past, Farmington was the only CHES testing site in the state. To make the certification program more affordable the fee for the exam has been reduced and continuing education has become easier.

There will be a great need for professional health educators in each community in the near future. Guidance counselors, prospective college students and parents should look into public health education as an option for future careers

Professionals who already have careers in health and human services such as nursing, social workers, athletic trainers and physical educators can also get CHES certification based on their eligibility. The opportunities for careers in health education are endless as well as crucial.

Srijana Bajracharya, Ph.D, is a professor of health education at the University of Maine at Presque Isle.