Dr. Bartlett gave a presentation on government and corporate veterinary practice, student debt, and the future of food animal medicine. He discussed how the veterinary industry is consolidating, leading to larger farms and corporations. This may result in veterinarians being employed more by large companies than working in private practice. Additionally, rising student debt levels and an oversupply of veterinarians has led to economic challenges for new graduates. Going forward, veterinary expertise will still be needed but focused more on public health issues across the food system rather than at the individual farm level.

1. Pre-vet club Mon Nov 11, 2013
Dr. Bartlett
Pre-vet club
Monday Nov 11, 2013
Dr. Paul Bartlett
"Government and Corporate
Vet Practice, Student Debt
and the Future of Food
Animal Medicine"
https://www.google.com/search?site=imghp&tbm=isch&source=hp&biw=1024&bih=653&q=food+for+thought&oq=Food+for+t
&gs_l=img.1.0.0l10.10320.12279.0.14156.10.10.0.0.0.0.113.684.9j1.10.0....0...1ac.1.27.img..0.10.684.9uBbbYzif0#facrc=_&imgdii=_&imgrc=iuGiacGLvqlWqM%3A%3BqBjBEnrjQ-tRAM%3Bhttp%253A%252F%252Fbrandingvaluenow.com%252Fwp-
1
content%252Fuploads%252F2007%252F07%252Fepa1313l.jpg%3Bhttp%253A%252F%252Fzandbelt.wordpress.com%252F2013%252F05%252F19%252Fdealing-with-a-rare-disease-such-asrelapsing-polychondritis-food-for-thought%252F%3B400%3B390

2. Introduction
• Paul C. Bartlett DVM, MPH, PhD
– BA – Zoology. U. of Wisconsin
– Madison
– Masters of Public Health (Epidemiology)
• U. of Minnesota – Mpls.
– DVM – U. of Missouri
2

3. Introduction
– Epidemic Intelligence Service – Centers for Disease control
and Prevention
– Board certifications
• Am. Col. Vet. Prev. Med.
• Am. Co.. Vet Prev. Med. – Epidemiology Specialty
– PhD – Ohio State U. – Columbus
• Contact information:
– 171 Food Safety Building
884-2016 Office
– Bartlett@cvm.msu.edu
• Email is the best method of contact
• Research:
–
Antimicrobial resistance, dairy epidemiology, foodborne
outbreaks, surveillance programs, norovirus, C. difficile,
Vancomycin-resistant Enterococci, MRSA, food safety, Shiga
Toxin E. coli, bovine leukemia virus, others.
3

4. Introduction
• Teaching
– Veterinary Public Health, Zoonotic Diseases, Epidemiology,
foodborne disease control, outbreak investigation, surveillance
programs,
– DVM Students
•
•
•
•
•
•
•
VM 544 (this course)
VM 533 (Vet Epi)
VM 532 - VIPS
LCS 678 – Gov and Corp Vet Practice Clerkship (The field trips)
LCS 690 – Vet Public Health Practice Clerkship
LCS 691 – Vet Public Health Research Clerkship
LCS 613 – Special Problems Clerkship
– MS in Food Safety
• VM 830, VM 831, VM 832, VM 821, VM 817
– Masters of Public Health program at MSU
• HM 803, HM64 – Epidemiology and Public Health
4

5. Some disjointed observations
first – then discussion
5

6. High Debt and Falling Demand
Trap New Vets NY Times Feb 23, 2013
• http://www.nytimes.com/2013/02/24/business/high-debt-andfalling-demand-trap-newveterinarians.html?pagewanted=all&_r=0
6

7. Associated Graphic:
Decreasing visits to the veterinarian
Decreasing number of U.S. pets
Increasing number of new veterinarians each year
Increasing avg. debt load per vet
Decreasing avg vet starting salary
http://www.nytimes.com/interactive/2013/02/24/business/Veteri
narian-Squeeze.html?ref=business
7

8. Executive summary of the 2013 US
Veterinary Workforce Study
• JAVMA 242 (11):1507 June 1, 2013
• http://avmajournals.avma.org/doi/pdf/10.24
60/javma.242.11.1507
“The recent National Research Council report found little
evidence of workforce shortages in most fields of
veterinary medicine and expressed concern that the
profession is confronted with an unsustainable economic
future owing to the large number of veterinarians being
trained and the high debt levels of new graduates.”
8

9. Study IDs Excess Capacity in
Veterinary Workforce
• JAVMA June 1, 2013
• 11 to 14% underutilization projected
through 2025
• “The demand for veterinary service in 2012
was sufficient to fully employ just 78,950 of
the 90,200 currently working in clinical and
nonclinical settings.”
9

10. But . . .
• Are other professions hit just as hard?
– Lawyers? Physicians? Professors?
10

11. Some thoughts about food
animal vet practice
11

12. Consolidating Food Industry
• The old agrarian agricultural system is disappearing.
• Today: Industrial Model (2009)
–
–
–
–
–
–
The top ten food retailers sell > 75% of food
The top four beef packers process >80% of beef
The top ten chicken companies produce 79% of the chicken
The top 50 dairy cooperatives produce 79% of the milk
The top 60 egg companies produce 85% of the eggs.
The top 20 pork producers produce 50% of the pork
• 2% of producers produce more than 80%
Source: Charlie Arnot - What food producers really want. International Conference on the Use of Antimicrobials
in Cattle Production. May 27 - 29, 2009 Kansas State University.
12

13. U.S. Dairy Farms & Cows
140
120
100
80
60
40
20
0
Average Herd Size
(Cows)
140,000
120,000
100,000
80,000
60,000
40,000
20,000
0
19
92
19
93
19
94
19
95
19
96
19
97
19
98
19
99
20
00
20
01
20
02
20
03
Cows (x100
) & Herds
(1992-2003)
Cows (x100)
Source: USDA-NASS, AFBF, FASS
Year
Herds
Herd Size
13

14. Idaho dairy vets vs. Wisconsin
dairy vets
• Sorry – I can‟t find the reference
• Idaho dairies were much bigger than
Wisconsin dairies, and had many more
cows per vets than did Wisconsin.
• Idaho (not Wisconsin) represents the future
of the industry.
14

15. In the future,
veterinary expertise will
be needed for issues
important to the “public
good”. But not easily
charged to an
individual farm.
Biosecurity
Animal welfare
Food safety
Food security
(supply) 15

16. What role will future veterinarians play in
food animal medicine? – Bartlett‟s opinion
It may be very different from the private practice situation that we
now see.
As the food industry consolidates and becomes more vertically
integrated, veterinarians may need skills in food safety issues to
enable them to work up and down the food chain rather than only
being involved at the production unit (farm). “Food Systems
Approach”
Food animal veterinarians may more likely be employed by a large
company or by a regulatory agency – rather than working in private
practice.
16

17. Physical hazards of food animal
vet practice
• My Dad‟s classmates
17

18. (Larson, The far side)
18
“Like most veterinary students, Doreen breezes through Chapter 9.”

19. What is Preventive Medicine?
• Preventive not “preventative” medicine
– And there are no “preventative drugs” to give to animals
so they won‟t get sick.
• What is “preventive medicine”?
-Objective of clinical medicine = “cure the sick
individual animal or person”
-Objective of preventive medicine “solve the
disease problem”
- The River Story
19

20. Veterinarians in Public Practice
• Public practice is corporate or government practice.
• It is unlikely that public health veterinarians will saturate the
public health “market”.
• Historically there have been plenty of jobs given:
– the relative sizes of the two professions
– The rapid and successful movement of veterinarians into
the interdisciplinary areas.
• The MDCH has about 9 DVMs and only about 2 MDs.
• But - Public employment may be considerably reduced in
future years if government continues to shrink.
– However, private practice may be tough too.

21. Engineering
Public Health
Others
Interdisciplinary
Territory
Microbiology
Vet Medicine
Human Medicine

22. Engineering
Public Health
Others
Interdisciplinary
Territory
Microbiology
Vet Medicine
Human Medicine

23. Engineering
Public Health
Others
Interdisciplinary
Territory
Microbiology
Vet Medicine
Human Medicine

24. Veterinarians in Public Health
• Why do DVMs fare so well in public health ?
– Excellent public health and epi courses?
• Our students learn Medicine
– Basic medical sciences (Pharm, Tox, Anatomy, Physiol,
Micro, Path, etc.)
– They are fluent in the language of “Medicine”.
• Can understand a (human) patient‟s chart.
– Disease diagnosis and treatment
– Aseptic technique/hygiene
• Mostly learned in surgery
– Disease transmission and disease control
– Vets are taught a population perspective.
• More so than are physicians.
– Disease surveillance, outbreak investigation, etc.
• We are taught to be problem solving generalists.

25. Why the Increased interest of students wanting to
specialize in public practice?
• Recent news events
– BSE, FMD, Bovine TB, E. coli, SARS, Monkey Pox, H5N1
Avian influenza, 2009 – H1N1, foreign animal disease,
Salmonella, frequent food recalls.
– Biodefense (most „Priority pathogens” are zoonotic).
• Life Style
– 40 hr wks, not “on call”, stable salary, no business
responsibilities, less economic risk, vacation days, sick leave,
holidays, health plan, etc. Salaries have improved relative to
private practice.
• Job opportunities
– U.S.is/was re-building our public health infrastructure after
about 50 years of disrepair.
– Maybe private practice has become less attractive. (Corporate
practices, student debt, disappearing middle class,
diminishing disposable income for pets, etc.)

26. Examples of Vet Public Practice Jobs
• Public health departments (federal, state or local)
• USDA (Vet Services, Food Safety Insp. Serv., Animal Care,
Fish and Wildlife)
• FDA, DHS, EPA, CDC, NIH, USPHS
• Local Animal Control
• Uniformed Services (US Army, USAF, USPHS)
• International organizations
• Private industry (pharmaceutical, vaccine, animal feed, food
industries, medical device)
• Specialties: Risk commun., food safety, zoonosis control,
disaster preparedness, occupational health, teaching & research,
epidemiology, environmental health, animal control
• Note: Many public practice vets do some private practice on the
26
side.

27. Careers in Vet. Prev. Med.
• 75% of all veterinarians are employed in
private practice
– They relate to public practice veterinarians for
disease control programs, regulations and
disease reporting.
– They prevent zoonotic disease among their
clients.
• Consider PubH with every Dx and every Tx
• 25% of veterinarians are in public practice
(not privately employed)
– But perhaps actually quite a bit higher.
27

28. Veterinary Preventive Medicine
• Where public practice veterinarians are employed:
– 27% Federal
– 37% University
– 20% Industry
– 9% State and Local Government
– 7% Armed Forces
• Predictions for Vet Med: Biggest growth areas are
expected in population medicine, preventive medicine
and other kinds of public practice.
• 9/11 has spurred our nation to rebuild it‟s public health
and regulatory institutions.
– Means more jobs for preventive medicine veterinarians.
28

29. Current Professional
Activity of U.S.
Veterinarians – based on
But – AVMA membership is much
lower among DVMs that have
moved away from traditional
veterinary clinical practice.
High dues. Membership not needed
if you don’t need the practice
insurance. Professional orientation
shifts to specialty organizations.
AVMA membership
3500 1500
1800
4500
250
2500
Clinical Practice
Federal Government
State Government
Academia
Industry
Retired
Other
70000
29

30. Public Health Veterinarians in the
Federal Gov’t
HHS-CDC
20
15
11
105
2
6
2
82
HHS-NIH
HHS-FDA
85
97
USDA-FSIS
USDA-APHIS
407
USDA-ARS
6
Coop State Research, Ed,
Ext
DOD-Army
30
DOD-Air Force
1043
637
Environmental Protection
Agency
DOI-USGS
DOI-Fish and Wildlife
DOI-National Park Service
Total: ~2,400
DO Commerce
DOS/USAID
30

31. Veterinarians at CDC
As of September 2003
3
6
11
6
18
State Health Departments
Reproductive Health
Health Statistics
7
4
Occupational Safety &
Health
AIDS/STD
Emerging Infectious
Diseases
Immunizations
Environmental Health
36
Global Health, Lab Safety,
Terrorism Preparedness
Total: ~82
31

32. • Federal public service loan repayment plan
http://www.finaid.org/loans/publicservice.phtml
• "The College Cost Reduction and Access Act of 2007
established a new public service loan forgiveness program.
This program discharges any remaining debt after 10 years
of full-time employment in public service. The borrower
must have made 120 payments as part of the Direct Loan
program in order to obtain this benefit. This is for federal
stafford (subsidized and unsubsidized) loans.
• The 10 years must be in local, state or federal government
(or some NGOs)
32

33. Federal Loan Forgiveness
• Diane Batten batten@msu.edu, MSU Financial Aid
• The 10 years do not need to be consecutive.
• Pay 10% of your salary for 10 years and you are
done! No taxes on the amount forgiven.
– So the total amount you owe becomes irrelevant. This
encourages some students to go ahead and get a second
(dual) degree.
• But will they cut the program in the future?
33

34. Veterinary Preventive Medicine
• Career limitations for DVMs are largely self imposed:
– The human medicine community welcomes us as part of the
preventive medicine team.
• Summary:
– Keep an open mind about public practice.
• Never say “never”.
– If you are interested in public practice, plan your clerkship
years of vet school wisely.
– Make an appt to talk to me sometime.
34

35. The Public Awakens to Links Between
Animal and Human Health
35

36. The Public Awakens to Links Between
Animal and Human Health
Beef recall hits record 1.2 million
pounds
USDA questions delay in recall of E. coli-tainted meat
August 15, 1997
WASHINGTON (CNN)
36

37. Bio and Agro Terrorism
Avian & swine
Influenza - H5N1
2009 H1N1

38. NIH Priority Pathogens
Category
A
B
C
Bacteria, Rickettisia,
Toxins
Anthrax; Botulism;
Plague; Tularemia
Viruses
Smallpox
Viral Hemorrhagic
Fevers
Brucellosis; Epsilon
toxin of C. perfringens;
Glanders;
Staphylococcus,
enterotoxin B; Q Fever
Multidrug-resistant
tuberculosis
Total
(% Zoonotic)
6 (83%)
5 (80%)
Hantaviruses; Nipah
virus; Tickborne
encephalitis viruses;
Yellow Fever
4 (80%)

39. The Future looks good for Applied Veterinary Public
Health Research and Disease Control of Emerging
Infectious Diseases
39

40. Public Health, Food Safety and
Food Animal Medicine
• Where will veterinarians fit in?
40

41. Corporate and Government Veterinary
Practice Clerkship (LCS 678)
• “The Field Trip” Clerkship
– Field trips every day (except for one).
• It is the “sampler plate” of veterinary public
practice.
• Offered in spring 5 of your 3rd or 4th year.
• Addresses the breadth of the veterinary
profession.

42. Corporate and Government Veterinary Practice
Clerkship (LCS 678)
• It is experiential learning.
– No nasty quizzes or exams.
– Lets you walk around in someone else‟s shoes for a
while to:
• Learn about their job, and
• See if you could imagine yourself in their job.
– You will meet about 60 veterinarians employed in
many aspects of veterinary public practice

43. Corporate and Government Veterinary Practice
Clerkship (LCS 678)
• Gets you out of the ivory tower and into the
real world.
• Transportation provided (MSU motor pool
mini-vans).
• Designed for students:
– Students heading into public practice
– undecided about their career path and looking
for ideas.

44. Day at the Detroit Zoo
One or more of the zoo
vets also join our tour to
tell about their work.
Dr. Kurt Hammel lead
a USDA Animal Care
Inspection of the
Detroit Zoo. You get
to see the “backstage”
as well as the “front
stage”.

45. Zoetis Animal Health, Kalamazoo, MI
•
•
•
•
•
•
Pathology Tour
Toxicology
Clinical Research
Clinical Support – customer support
New Animal Drug Development
Tour of their lab and farm animal research
facilities
45

46. Wright-Patterson Air Force Base – Meeting with lots of Army
and Air Force Veterinarians

47. A visit to the Air Force Museum before
heading back to MSU

48. Wright-Patterson Air Force Base – Pathology, Lab Animals, Public
Health, Clinical Medicine, Military Working Dog Demo.

49. USDA:APHIS:VS
Get to meet about 7 Vet Services veterinarians and hear about
their jobs.

50. MPI – Contract Research Laboratory
(Just E. of Kalamazoo)
• Great tour
• Pathology and Clinical Pathology
• Laboratory Development
• Toxicology
• Microbiology
• Research Design, Animal Studies
50

51. CDC and DHS
• Conference calls with Power Points slides
and lots of questions.
– With three clerkship alumni who now work for
CDC
51

52. Detroit Border Inspection
• USDA:APHIS:VS – Ambassador Bridge
International Port (Import/Export work)
• Detroit Metro Airport
– CDC Quarantine Station
– USDA inspection procedures
• Beagle Brigade demonstration
• X-ray surveillance of luggage for food items
• View confiscated materials
– Wildlife prohibited substances
• Ivory, hunting trophies, etc.
52

53. Dow Chemical
• Pathology tour
• Occupational and environmental
epidemiology tour
• Aquatic laboratory tour
• Laboratory Animal
• Toxicology tour
53

54. FDA – Detroit Office
•
•
•
•
Meet 3 or 4 FDA veterinarians
Food Safety
Animal and human drugs
Antimicrobial resistance field work
Inspect Detroit Animal Control while we
are downtown.
54

55. Michigan Department
of Agriculture
Veterinarians
- Inspect Sundance
Riding Stables.
Also inspect Capital Area
Humane Society.
Dairy Processing Plant
Beef Feedlot

56. Michigan Department of Community
Health
• Meet with about seven MDCH veterinarians
at the Office of Public Health Preparedness
(OPHP) incident command center.
–
–
–
–
Avian Influenza
Communicable Disease Surveillance
Chronic Disease
Environmental Health
• Tour the MDCH laboratories
56

57. Packerland and Michigan Turkey
Producers
USDA:FSIS Meat Inspection
• Maybe your last chance to see where meat
comes from.
FSIS-led tour of a turkey plant and a beef plant
57

58. International Veterinary Medicine
• The one day “at home”
• A role-playing table-top exercise regarding
international animal disease control.
• International Veterinary Medicine
Opportunities.
58

59. Summary of Corporate and Government
Veterinary Practice Clerkship (LCS 678)
• See the real world and learn about possible
specializations!
• Meet about 60 public practice veterinarians
– Contacts for future clerkships, summer jobs, etc.
• Good experience for if you are applying for a
public practice job someday.
• Always lots of fun!
• Spring 5 in your 3rd or 4th year.
59

60. LCS 690 and 691
LCS 690 – Public Health Field Experience
LCS 691 – Public Health Research Experience
• LCS 691 requires a summary paper.
Can do any of about 100 different things with
these clerkships.
A graded “Public Health Field Experience”
looks better on your transcripts than does a
pass/fail “Externship”.
60

61. LCS 690 and 691
• Provides you the flexibility you need to get the
education you want.
• Usually about 20 students per year enroll, all at
different times.
• Can take LCS 690 twice and LCS 691 once.
• Students working on an MPH or MS in Food
Safety can count this as their practicum.
61

62. Most Popular Uses for LCS 690/691
• Centers for Disease Control Senior Epidemiology Elective
• USDA:APHIS:VS veterinarians in Michigan
• Animal control offices, humane soc. or spay/neuter programs like
CSnip
• Michigan Department of Community Health
• USDA:FSIS food safety inspection
• U.S. Army or Air Force; FDA, DHS, other agencies
• Michigan Department of Agriculture, Animal Industries
Veterinarians
• Mich. DNR or various wildlife programs
• Other state‟s agriculture or health departments
• International programs
• Plus many more (Dr. Bartlett can send you a complete list of
possibilities)
62
• Industries: Zoetis, Dow Chem., MPI, other

63. LCS 690 and 691
• You set up these experiences yourself (with my help as
needed).
– That‟s part of the whole experience. You can‟t just
show up on the first day and ask where you are
supposed to go! (That‟s only happened once!)
– You can sign up for these clerkships before your plans
are solidified as to what specifically you will do.
– Complete and sign Bartlett‟s 1-page form
• It very much helps your job application to an agency if you
can demonstrate that you know what the job entails. LCS
690 is how you get that experience!
• Essentially no min or max, and I‟ll always let you drop or
add.
63

64. Dual Degrees (General): DVM, MPH or
DVM, MS in Food Safety
• Never have to take DVM and masters courses
in the same semester
– but some students do this to save money via block
tuition.
• Admission and courses are generally easier
than vet school.
• Get at least a start on the 2nd degree early when
it does the most good for job applications
64

65. It’s all about “Double Dipping”
• Starting your masters now can mean about 1/3 off MPH
or 1/3 off MS in Food Safety.
• If you stay in public practice, you‟ll probably want a
master‟s eventually.
• Get your field experience/practicum project done when
you are a CVM student.
– It is harder to do a practicum when you are working full time.
– As a ckerkship or as part of summer Food Animal Fellow or
NIH program (Drs. Grooms and Vilma Yuzbasiyan-Gurkan)
• Public vet practice is getting more competitive, and a
masters degree helps you compete early in your career.
65

66. But – you might want to wait
• You may fall in love with private practice
– You may want to wait on a masters until you
are sure you want to move into public practice.
• You may want to concentrate on one degree
at a time to “get your money‟s worth”.
• You may need your summers to recover
your sanity.
• And it is expensive on top of the DVM.
66

67. MSU’s MPH program:
• http://publichealth.msu.edu/pph/
• 42 credits. All online. No out-of-state tuition for anyone. 9
credits transfer from your CVM courses.
• If you take public health field experience (LCS 690 & 691)
clerkships and sign up for the 4 cr of MPH practicum (HM
891 and 892) at the same time, then you will save your
time, but will not save any money.
• Double dipping: If you take HM 803 (Epi) and HM 864
(Intersect of An. and Hu. Health) before 3rd sem of vet
school, then you won‟t have to take VM 533 (Epi) or VM
(544) in your 3rd semester of vet school, thereby freeing up
time in 3rd semester to take MPH courses for free under
block tuition.
• Savings: 15cr / 42cr = 35% off ($660. per credit)
67

68. MPH at MSU
• Most students apply for the MPH program during
their 1st year of vet school.
• Dr. Melinda Wilkins wilkinsm@msu.edu works
for the MPH program and is the advisor to
virtually all of the DVM/MPH students.
68

69. What if you are not accepted into vet
school on your first attempt?
• An MPH degree can be a good move
– It gives you a chance to pull up your GPA.
– It strengthens your application to vet school
– It adds value to your DVM if you eventually
get one.
– It leads to a viable career if you never get your
DVM.
• It is not a dead end like taking courses outside of a
degree program. “Life-long education”
69

70. MS in Food Safety
• http://www.online.foodsafety.msu.edu/
• 30 credits, of which 9 can transfer from vet school.
• Students mostly are working for Food Companies
(75%) and food regulatory (25%).
• Good for students with a strong interest in food
animal medicine
• Do practicum in summer or during clerkships.
• See Dr. Julie Funk who is the program‟s director.
70

71. The History of Preventive
Medicine
How do we usually measure the
“Success” of an animal species?
Population
71

72. Graph of the Human Population Over Time
Pop in Billions
• Two inflection points:
– At the time of the
Estimated Global Population
Agricultural
7
revolution
6
5
– At the time of the
4
Industrial revolution
3
2
• Due to improvements in
1
nutrition, disease control
0
practices and sanitation
-10,000
-2000
-500
0
Years ago
– All of which are key
elements of preventive
medicine.
http://www.census.gov/main/www/po
– Clinical medicine was
pclock.html
pretty ineffectual in the
ancient world.
72

73. Infectious Disease Mortality
Antibiotics
73

74. Preventive Medicine
• The major health improvements in our civilization
were made before the advent of antibiotics or
much effectiveness of individual (curative)
clinical medicine.
• Epidemic disease has largely been controlled
through preventive medicine by:
– Sanitation and hygiene (food hygiene, pest control,
vector control, reservoir control, etc.)
– Good nutrition (food animal medicine helps makes food
plentiful and affordable)
– Disease control measures (education, food safety,
isolation/quarantine, vaccination, eradication, control of
animal disease reservoirs.)
74

75. Summary - Preventive Medicine
• The increase in the human lifespan is
mainly due to preventive medicine.
– Perhaps your garbage collector contributes
more to your health than your physician.
• The natural state of mankind is disease and
squalor.
– It is preventive medicine that freed us from this
desperate situation.
– Epidemic disease quickly returns when
preventive medicine infrastructure breaks
down.
75

76. Wisconsin Death Trip by Michael Lesy
Life in the “good old days” was not that good.
Uncontrolled infectious disease greatly diminished the
quality of life.
• Life was very stressful.
– Quarantine signs on doors of houses.
– Limited movement (public gatherings rare, meat
purchased cautiously, restaurants rare)
• Stress is when your children die,
– not when you can‟t find a parking place at the mall.
• Last 100 years in the U.S. is an aberration from the
normal stressful human existence of desperate poverty
and squalor.
76
• True stress is not having any choices.

77. The “Good Old Days”?
The “Good Old Days”
High Infant Mortality Rate
Suicide
Wisconsin Death
Trip by Michael
Lesy
Insanity
Religious dementia
Poverty
77
Untreated Depression

78. One more word about stress
• I‟m not saying we don‟t have stress now
days.
• I‟m saying we should have incredible
respect for the stresses endured by our
ancestors
– And be inspired by their perseverance
– And encouraged that our bodies and minds
were made to survive stressful situations.
78

79. U.S Infant Mortality Rate
79

80. The Sanitary Hypothesis
Rank
Infant mortality rate
country (deaths/1,000 live The number of deaths of infants under
births)
one year old in a given year per 1,000
1 Afghanistan 121.63
live births in the same year;
2 Niger 109.98
3 Mali 109.08
68-fold difference between highest and
4 Somalia 103.72
lowest, i.e. 68 times more dead children.
....
218 Sweden 2.74
Yes – you get healthier adults – if they
219 Singapore 2.65
survive, but look at the cost!
220 Bermuda 2.47
221 Japan 2.21
United States is 174th 5.98
222 Monaco 1.80
Source: https://www.cia.gov/library/publications/the-worldfactbook//rankorder/2091rank.html?countryName=Norway&countryCode=no&regionCode=eu&rank=212#no
80

81. In Conclusion
Disease and Squalor has been controlled
by:
“Public Health Infrastructure”
Sewers, clean water, garbage disposal, pest control
(dog pounds), health department disease control,
dairy and meat inspection, pharmaceutical
licensure, vector control, reservoir control, etc.
Veterinarians participate in all these activities.
81

82. I hope I didn’t “oversell” my message.
• You can still be a good person even if you decide to specialize in
something other than public health.
• Keep in mind that all veterinarians practice public health in some
aspects of their work.
• There are many worthwhile specialties in veterinary medicine.
• Each professor states their best case to get you interested in their
specialty.
– But we all realize that veterinarians are needed in many
different areas.
82

83. Paul Bartlett, DVM, MPH, PhD
Professor
College of Veterinary Medicine
bartlett@cvm.msu.edu
83