The roots of Tufts' Department of Community Health go back to 1930, when the medical school established a Department of Preventive Medicine with Commonwealth Fund support, appointing Dr. Dwight O'Hara as the first professor. When Dr. O'Hara retired in 1957, the department was reorganized under the leadership of Drs. Count Gibson and H. Jack Geiger, and its name was changed to "community health and social medicine." Drs. Gibson and Geiger adopted a community-oriented focus and went on to initiate a variety of outreach activities, including the direct delivery of health services to under-served populations. These efforts led to the development of the Columbia Point and Mound Bayou projects, for which the department attained national recognition.

At this time the department supervised both teaching programs, such as the Home Medical Service, and preceptorships in neighborhood clinics and physicians' offices; however, it had few other educational responsibilities. Thus, when Drs. Gibson and Geiger left Tufts in 1969 and 1971, respectively, the department was abolished and its residual activities were absorbed into the Community Health Group under the aegis of the Dean's Office. The Home Medical Service was discontinued, and teaching activities were limited to elective seminars and presentations in conjunction with other courses.

However, in 1977 Dean Lauro Cavazos asked Dr. Morton Madoff to help evaluate the activities of the Community Health Group and to begin the development of a program for teaching, research, and service. Over the next few years, the Community Health Group undertook a number of initiatives, including the management of the Tufts' Maine Area Health Education Center Program; the development of a health maintenance organization - the Tufts Associated Health Plan; the establishment of a program of family medicine; the organization of a primary care internal medicine residency program, in cooperation with the Faulkner Hospital; the institution of a course in biostatistics and epidemiology; and the initiation of a primary care preceptorship program for first- and second-year medical students.

In 1980, when the Department of Community Health was reinstated, Dr. Madoff, who had been serving as director of the Community Health Group, was appointed acting chair. He was appointed chairman in 1981. Under his leadership, significant curriculum changes were instituted, including the addition of a lecture series on community health issues and of required courses in ethics, the organization and financing of health care, and family medicine. With the help of Area Health Education Center funding, a primary care clerkship was initiated at the Baystate Medical Center, clerkships in family practice programs were established in Maine, and a pediatric clinical clerkship was developed at the Eastern Maine Medical Center. In 1986 the department introduced the combined M.D./M.P.H. program, which permits a select number of medical students to receive both the doctor of medicine and master of public health degrees in four years. This program is designed to respond to the growing need for physicians to possess an understanding of health promotion, disease prevention, epidemiology, the environment, health planning, and global health problems. The course recently received full national accreditation.

In recent years the Department of Community Health has also sponsored numerous research and service activities, such as a program for delivering health services to the institutionalized mentally retarded (in cooperation with the Department of Neurology); a research project focusing on the physician's role in health promotion and disease prevention; and a variety of environmental studies (in partnership with Tufts' Center for Environmental Management). From 1983 to 1986 the department was also responsible for developing and implementing the human health component of the Tufts/Niger Integrated Livestock Project. Moreover, it continues to be the major link to the Tufts Associated Health Plan and utilizes the plan as a laboratory for health services research.

In 1987 the department was selected to be one of six recipients of a five-year Pew/Rockefeller Health of the Public Award, designed to encourage the development of a population-based perspective. Within the context of this program first- and second-year students participate in a variety of health-related activities that are not part of the regular curriculum but which provide them with exposure to the area of public health. This program has also made it possible for the department to initiate a required ambulatory care clerkship in the clinical years and to introduce courses in addiction medicine, nutrition, and immigrant and refugee health care. The primary mission of the Department of Community Health continues to be that of providing students with the skills, knowledge, and perspectives needed to understand the link between social, physical, and economic environments and the health of individual patients.

Source: COE, 129-31.

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