In the face of demographicchanges in our society anddramatic financial implications
for the organisation of health serv-ices, politicians are becoming moreand more aware of the relevance ofpublic health. Numerous institutionswithin the Munich metropolitan areaare working on answers to new,pressing questions. Interdisciplinaryexchange and a platform for commonaction need to join forces. TheMedical Faculty of the MunichUniversity (Ludwig-Maximilians-Universität), the HelmholtzZentrumMünchen, and the BayerischeLandesamt für Gesundheit undLebensmittelsicherheit (BavarianHealth and Food Agency) establishedsuch a platform for Munich by settingup the Pettenkofer School of PublicHealth (PSPH).
Max von Pettenkofer (1818-1901),the eponym of the Pettenkofer Schoolof Public Health Munich, consideredhealth not only as a medical issuebut also as a social, economic, tech-nical and epidemiological challenge.He can be considered the founder of‘Public Health Research’ in Germany.
The new Munich approach to publichealth research perceives individualhealth as a reaction of the subject tohis/her interaction with a complexsurrounding system. It makes publichealth research a systems science,based on input from molecularbiomedicine, clinical medicine,epidemiology, social, as well aseconomic, managerial and politicalsciences. The partners of the PSPHdevelop research projects that bringthis idea to life.
The Institute of Epidemiology at theHelmholtz Zentrum covers a widespectrum, including classical cohorts,molecular epidemiology, environ-mental health research and geneticepidemiology. It supervises the KORAcohort, which turns the town ofAugsburg into a health laboratory andprepares major contributions to theGerman National Cohort, a long-termcohort study including 200,000adults. “The goal of the study will be
to illuminate the causes of commonhealth problems like cardiovasculardisease, cancer, diabetes anddementia, as well as to identify riskfactors and effective methods ofprevention,” says Professor H ErichWichmann, Director of the institute.
‘Max von Pettenkofer,the eponym of thePettenkofer School ofPublic HealthMunich, consideredhealth not only as amedical issue butalso as a social,economic, technicaland epidemiologicalchallenge.’
The medical faculty of the LMUMunich has a strong interest in thetranslational fields of research
Not just a medical issue...Public health research in Munich
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1 Public Service Review: European Science & Technology: issue 9
between basic sciences, clinical andpopulation-based medicine. Researchmethods that were initially developedfor clinical purposes are now increas-ingly employed for epidemiologicaland etiological research in healthypopulations. Results of clinicalresearch are the starting point forpopulation-based prevention, andepidemiological research is translatedinto clinical practice.
These activities create four newperspectives in medicine: first,predictive medicine where insightsinto the genome and proteome offernew views on the prediction of indi-vidual health trajectories. Secondly,preventive medicine provides inter-ventions to prevent a disease. Thirdly,personalised medicine allows treatment for a patient consideringhis/her genetic variations. This alsoincludes means for assessing apatient’s probability to respond to
treatment. Finally, in participatorymedicine, patients are informedabout their health perspectives andare involved in medical choices andcure, acting in partnership withhealthcare providers. “Implementingthis new paradigm into our healthsystems needs translation betweenthe fields of clinical medicine,epidemiology and public health,”says Professor Ulrich Mansmann,Director of the Master’s programmesoffered by the PSPH.
Effective public health requires thedevelopment, implementation andevaluation of effective programmesand policies in public health. Inspiredby the concepts of evidence-basedmedicine, the translation of newconcepts into programmes requiresthe application of principles of scien-tific reasoning, including systematicuses of data and informationsystems. “This idea is gainingmomentum – nationally as well asinternationally,” says ProfessorManfred Wildner from the BavarianHealth and Food Agency. “It is thebasis of the needed informedchoices of society, organisations,public and private, communities andindividuals for promoting healththrough organised efforts.”
The PSPH establishes the neededinfrastructure between people andinstitutions contributing to theseendeavours. A new generation of
scientists will be trained to have abroad understanding of the clinicaland methodological foundations ofpublic health. A clinician will receivethe broader perspective of strategiesthat can be used when counselling ortreating a patient. Epidemiologists andpublic health experts will be trained tocomprehend the potential of basicmedical research to design strategiesthat improve health services in general(screening, cost-effective treatment,health promotion strategies, etc.). Thecareer perspectives of these studentsare excellent.
As a result, substantial and uniquecompetence in the field of quantita-tive health sciences is emerging inMunich.
Professor Dr Ulrich MansmannChair of Biometry and Bioinformatics,Director of IBE and Spokesman for thePettenkofer School of Public Health
Pettenkofer School of Public HealthIBE, Univeristy of MunichMarchioninistrasse 1581377 Munich Germany
Tel: +49 (0)89 7095 4491Fax: +49 (0)89 7095 7491
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2Public Service Review: European Science & Technology: issue 9
