BY LINDA ROSENSTOCK

The events of Sept. 11 followed by the subsequent anthrax exposures and threats of more bioterrorism have focused a great deal of attention on the field of public health. Never before have the words "public health infrastructure" rolled off the tongues of so many in government, media and the general public.

While the circumstances that brought us this level of attention are unfortunate, the attention to the field is long overdue. For decades we have under-invested in the people, the technology and systems that protect our health.

In fact, the public health infrastructure receives less than 3% of the $1.2 trillion annual national health expenditures. An astounding 80% of the country's 450,000 public health workers are not formally trained in public health. To add insult to injury, each year the federal government spends only $2 million of its $300 million health professional budget for preventive medicine training. Of the Bush administration's proposed $1.6 billion for public health defense, $1 billion is slated for stockpiling antibiotics and vaccines leaving little for infrastructure improvements.

The need for bolstering the public health system is abundantly clear. A 1999 survey of city and county health departments found that 20% did not have e-mail capability, and that more than half did not have continuous high-speed Internet access. A survey conducted in October 2001 by the National Association of County and City Health Officials found that 80% of city and county health departments do not have comprehensive bioterror response plans in place. (A little more than half of them have plans under development.) In addition, 62% of health departments said they were only "somewhat prepared" or "not prepared at all" to answer the public's bioterror questions since Sept. 11. Furthermore, a 1998 study of 186 hospitals in Washington, Oregon, Idaho and Alaska found that over 80% had no plans for biological or chemical attacks.

Planning for such events has become a reality. However, even if there were no more threats of anthrax or other such exposures in our near future, such attention to bolstering a long neglected system - a system that often gets ignored because it is invisible when it is working best - will serve us all well in the years to come. Surprising to many is the fact that each year in the United States, 76 million people get sick, more than 300,000 are hospitalized and 5,000 die from food borne illness. An improved public health system would help detect, track and prevent many of these incidents.

As a leading school of public health, UCLA is positioned to be part of the infrastructure solution. The School of Public Health offers our students training in bioterrorism, public health preparedness and other disaster-related issues. In addition, we are uniquely positioned to train the health professional workforce of California and the West Coast in responding to these new threats of terrorism. The school is also well poised to become the national model for linkages between state and local health departments, academia and community services to provide the public health infrastructure necessary for the health risks we actively face on a day-to-day basis. By so doing, we'll be much better positioned to also respond to acts of terrorism.

Rosenstock is dean of the School of Public Health.