It was in the late 1980s that the dawning of recognition and subsequent acknowledgement occurred regarding the status of the nation*s public health infrastructure. The Institute of Medicine called it "disarray" in their report, The Future of Public Health. Webster's dictionary defines disarray as a state of "confusion, disorder [horizontal ellipsis] or an untidy condition." The circumstances that lead to untidy conditions or disorder are frequently the results of disregard, lack of attention to the consequences of neglect, and lack of sufficient financing, as is the case for public health.

With only a small allocation of health care dollars and relegation to a role of lesser importance in the health care system, public health amassed multiple achievements throughout the 20th century. The Centers for Disease Control and Prevention point to but a few of these achievements as the development and use of vaccinations; improvements in motor vehicle, food, and water safety; safer workplaces; infectious disease control; water fluoridation; improved health care for new moms and babies, as well as family planning; declines in heart disease and stroke mortality; and new emphasis and campaigns on changing lifestyle habits, like smoking, to improve individual and population health. Whereas much emphasis was placed in the 20th century on the leading causes of mortality like heart disease, cancer, and stroke, the public health system of the 21st century is reflecting on causes of disease and death such as obesity, smoking, drinking, and drug use, to name a few.

As a result of the recognition that promoting the health of populations and communities enhances all aspects of life like social, educational, economic, and environmental well-being, the public health system is revisiting its roots in the core functions of public health and the essential services that define the system's focus. To adequately address the mission of keeping the public healthy, educational processes for developing a competent workforce, evidence-based practices, and regulatory processes to support a renewed public health system are essential.

Public health is an arena in which collaborative efforts among public health providers is common practice. Whereas there are numerous public health providers, registered nurses comprise the largest group of workers in public health. Yet, registered nurses working in public health are prepared primarily at diploma school and associate degree levels. Those nurses who are prepared at the baccalaureate level, with few exceptions, have usually not been prepared for the complexities of providing services at the population and community level.

As a regulatory agency, in 1999, the Division of Nursing of the Bureau of Health Professions, Health Resources and Services Administration, USPHS, issued a call for proposals to develop pilot programs to enhance the education of baccalaureate nursing students with emphasis on population and community health, and on preparing a competent public health nurse workforce for the future. In this issue of Family and Community Health (27:4), the majority of the articles represent evaluations of the strategies used in these pilot projects. Although many of the themes are similar, the strategies to address the goal of these federal projects are different. One article addressed a nursing-funded project that looks at a developing new role for public health nurses, through an educational program, as child care health support personnel. This article clearly shows that as the public health system becomes more complex, new roles emerge for health providers. Finally, a research article highlighting the effects of a media-based community intervention in exercise and the collaborative nature of public health completes the issue. The future of public health rests in the hands of partners in regulation, the educational systems, and private and public agencies devoted to practice.