I can see the outlines below of water and glaciers, and it leads me to think about global warming, water and the future of public health. I hope everyone will read the latest issue of Carolina Public Health cover to cover http://www.sph.unc.edu/cph/. It is a magnificent tour de force that highlights the challenges of providing safe water to a world in need and catalogues and tells the story of the magnificent work our faculty members, especially those in Environmental Sciences and Engineering and the Institute for the Environment and Marine Sciences, students and staff are doing in this area.

The stories tell an interdisciplinary, cautionary tale, of people from public health, marine sciences, policy, economics and so much more, working together to solve problems that confront our civilization, indeed, our planet.

Being dean opened me up to the huge problems associated with water, something many of us have taken for granted for far too long. We turned on the shower and water flowed. Now, everywhere we turn, there are cautions and constraints regarding our use of water.

Water is public health. More than 1 billion people in the world lack access to safe water. Lack of access to safe water kills 4,000 children every day, according to the UNICEF (http://www.unicef.org/). Why don’t we get incensed about these preventable deaths? Because they happen to people who are poor and lack a loud voice?

While water is a vital resource without which we cannot survive as a species or planet, funding for water research is virtually an orphan, and our scientists must cobble together a little from here and a little from somewhere else.

Yet, the average person is starting to talk about water the way they talk about the weather. I notice it now with cab drivers and flight attendants, even the person on duty at the Department of Motor Vehicles office the other day (YES!). That’s a paradigm shift! People are starting to get that it’s a problem. And our school is right in the midst of it all, where it has been for more than 60 years, doing the fundamental research, translating it and making a difference.

I’d like to see more of my behavioral science colleagues thinking about the science of water-related behavior change. It is a perfect case study of the need for the social ecologic model (literally!). We need policy and organizational changes, behavior change from organizations, like big and small employers, and then all of us, each of us must think about water differently. We must change our individual behaviors and our collective ones as well.

This is a place where students can make a huge difference that will really matter. If I were a student today, it’s a problem I would consider addressing.

I heard a great interview on BBC Saturday morning November 10. They interviewed a reporter who’d helped to start a Web site called Circle of Blue that is created by journalists who tell fascinating stories, some about individuals and water. The pictures are astonishing. Check out http://www.circleofblue.org/.

I have been thinking about how subtly, imperceptibly, yet thoroughly one is transformed to take a global perspective on health. I am working with two colleagues (Drs. Karen Glanz and Vish Viswanath) who are co-editors on the 4th edition of our textbook. Sentences that are subtly U.S.-centric but never seemed obnoxiously so before, now seem inappropriate to me. We cannot simply talk about “the health care system” as though there is one at all. And even if there were one in the US, there are many around the world. Where once we could glibly talk about the transition from infectious diseases to chronic ones, we do that today only with the knowledge that we are ignoring millions of deaths a year, including millions that are preventable.

As the Worldwatch Institute ( http://www.worldwatch.org/) says:

All of the wars of the twentieth century are estimated to have resulted in the deaths of an average of 1.1 million combatants and civilians per year. But at present, communicable diseases are killing fourteen times that number of people annually.

I am not a scholar of global health, but I realized that like so many of you, I am changed by the recognition of our “globalness.” Once altered, one cannot - or at least I hope not! - return to one’s former state.

Our students are forcing us to change our thinking and practices. I struggle with what it means to turn out students who understand enough about global health to be competent at what they do without turning them all into global scholars - which we cannot do.

A recent article in the Chronicle of Higher Education by Philip Alcabes speculated that public health has become irrelevant, because it focuses almost exclusively on individuals’ health problems, has become obsessively moralistic and doesn’t address the real threats to health. The author argued that public health would be more relevant if it regained some of its focus from the early 20th century.

While the author did not get it all right, I believe he had some good arguments. We have the opportunity to redefine public health for the 21st century and to state clearly that it must address the problems of individuals, but that solutions should eradicate root causes of ill health. We are about individuals and populations, chronic and acute diseases, high technology solutions and the dissemination of simple solutions that people will adopt.

Achieving our goals often will require interventions that transcend individuals. It may mean altering health systems, changing payment structures for health care and altering what food and services are available to people. Individuals don’t exist in a social vacuum. Even those of us whose interventions have focused primarily on individuals should realize that sustained behavior change needs more than willing individuals in most cases. With the election approaching, we should not be afraid to engage in the political arena. Sustained changes require political will.

As we in the U.S. contemplate the choice of candidates for our next President, we should ask tough questions about their positions on health and health care, what they will do to encourage healthier lives and how they will work with schools of public health to achieve that. Whether we are talking about what foods should be available in school cafeterias, how to deal with droughts and how to finance health care for all, schools of public health have critical expertise to help define the issues and the arguments.

For months, I’ve been weighing the pros and cons of establishing a blog. It’s a significant commitment to you, the readers, and it’s no good if not kept current. But I’ve concluded that we do, indeed, have much to say to one another, so I have decided it is time to blog!

Why blog? Several reasons.

• First, I love the written word.
• Second, many times I observe something, and I want to communicate it to the School and beyond. Blogs are an efficient communications venue.
• Third, as dean of one of the world’s top schools of public health, I am privy to information and perspectives that may add value to what we all care about - improving life everywhere.

Equally important though, I hope “Monday Morning” provides a forum for you, the readers, to communicate with me. Please tell me what you think, know, believe and care about… The beauty of blogs is the potential for interactivity and connectivity.

As for the name of my blog, “Monday Morning” is fitting, because that’s when I plan to post new information. But also, the “Monday Morning” idea has rubbed off on me from this UNC culture of sports. After games, our coaches reflect on the weekend performances - wins and losses. I love listening to those discussions on the radio. Often, they are harder on themselves and their teams than any outside critic.

Weekends afford the best opportunities for me to reflect on issues of importance to our school and our field, so that’s when I’ll do my writing. I hope you will join me each week and participate in the dialogue.