It’s graduation season, which means that a new crop of public health practitioners will soon be entering the field, bringing with them new and creative answers to today’s most pressing health problems. And since the early 1950s, the Association of Schools of Public Health has been working alongside schools and universities to strengthen and advance public health education as well as promote public health as a career to pursue.
The association is on the forefront of developing new curriculums and competencies for a variety of public health disciplines. It’s also leading work to make sure public health education keeps up with the challenges and opportunities unfolding on the ground. Below, Harrison Spencer, MD, MPH, DTMH, CPH, the association’s president and CEO since 2000, talks to APHA’s Public Health Newswire about the future of public health education and his advice to new graduates.
Q: What do you think are some of the biggest and most interesting changes in public health education since you received your own master’s degree in public health (MPH)?
Public health education has continued to evolve since I received my MPH. Global health, undergraduate public health, joint degree programs and interprofessional education are prominent.
While core disciplines are similar, there is an increased emphasis on systems thinking, innovation, the evidence base for public health interventions and multidisciplinary approaches to problem-solving. The importance of a practicum for every student is highlighted. Management, finance and other administrative skills are increasingly taught. Students are more diverse, many enter public health immediately from college, there are fewer physicians, and career tracks are infinitely more varied.
Q: What public health disciplines are trending today and why have they become so popular?
Epidemiology will continue to serve as the “science” of public health, and the other four basic public health science areas (behavioral and social sciences, biostatistics, environmental health, and health policy and management) will continue to be taught and practiced. However, it is more in the way public health is framed and conceptualized that is driving change.
The entire health system, with the government public health infrastructure at the center, is now viewed in totality with both health (public health and clinical care delivery) and non-health sectors (the media and education, for example) as contributing to population health. Cross-cutting approaches — such as systems thinking, leadership, interprofessional education and practice, informatics and efficacious, evidence-based practice — are more important now than ever before.
Q: In 2003, the Institute of Medicine recommended that “all undergraduates should have access to education in public health” and that “public health is an essential part of the training of citizens.” Nearly a decade later, how far has undergraduate public health education come? And what do you believe are the critical components of an undergraduate public health education?
Both the Washington Post in 2008 and the Chronicle of Higher Education in 2011 reported that public health was one of the top majors among undergraduates. It is not always labeled “public health,” but whatever you want to call it, population health is exciting young people today.
Data from 2008 indicates that 137 of 837 (or 16 percent) of undergraduate institutions that are members of the Association of American Colleges and Universities offered a major, minor or concentration in public health. As of the summer of 2011, the College Board listed 511 colleges with majors in public health. Only 29 of these public health majors are located in schools of public health or universities with Council on Education for Public Health accreditation.
To answer the second part of your question, an expert panel of our association’s Framing the Future Task Force (which is considering public health education in the next 100 years following the 100-year anniversary of the Welch-Rose Report, which examined the need for educated and trained public health workers), has come up with a draft slate of Critical Component Elements (CCEs) for baccalaureate public health programs. The list of advisory recommendations can be found online.
The task force put the draft CCEs out for comment in April and May of 2012 and is considering revisions prior to finalizing the document this summer. The CCEs contain both curriculum components and program components. The curricular recommendations are comprised of: basic elements (inclusive of both content areas, such as math and quantitative reasoning, as well as skill areas, such as communications), nine core public health elements (such as the role and importance of data in public health as well as identifying and addressing community health challenges), capstone and field experiences, and professional dispositions and cross-cutting areas (such as professional etiquette, teamwork, ethical decision-making and advocacy).
Q: Should more efforts be made to introduce young people — specifically, high school and middle school students — to the field of public health? Are there some efforts already going on today that you think are particularly innovative?
Literacy in public health is as necessary today to function effectively as a citizen of the United States, and the world for that matter, as the “three Rs.”
Education in population health can start as early as elementary school, and there are successful examples of curricula and other innovative learning experiences in K-12 education across the country. Last year, we developed a model of public health learning outcomes for all undergraduates, regardless of the person’s major. So, whether the college student is studying dance, math, engineering or philosophy, we have a list of 34 outcomes that a national panel recommends students achieve to become “educated citizens.”
Schools are incorporating these learning outcomes into their curricula in very innovative ways. The fourth domain of the learning outcomes model includes 34 examples of integrative and applied learning experiences (one tied to each of the leaning outcomes) that are provided to help students exhibit the desired outcomes in real-world scenarios. All students as citizens, at some point, should be exposed to epidemiology 101, global health 101 and public health 101.
Q: According to data from the National Association of County and City Health Officials, more than half of local health departments have recently eliminated at least one program, and about 19 percent of the local health department workforce has been eliminated since 2008. What does this mean for public health students’ prospects?
We believe, along with our state and local partners, that the nation’s health and security are compromised by the governmental public health cutbacks you just mentioned. This erosion of the capabilities of state and local health agencies is a matter of grave concern for our nation and society and one that needs to be addressed.
However, our graduates enter a wide range of careers, including health systems, nongovernmental organizations, universities and research facilities, the private sector and so forth. Only about 20 percent enter into state, local or federal service. Our data suggest that despite uncertain economic conditions, our graduates continue to have strong employment prospects.
Q: Are you worried that such trends will discourage young people from pursuing public health as a career?
Graduates of schools of public health emerge with strong analytical and reasoning capabilities and with not just the desire, but with the tangible knowledge, skills and attitudes to make a real difference in improving people’s lives and the health of the communities in which we all live.
School of public health graduates learn how to ask the right questions about what is needed for effective solutions in light of a dynamic, multi-layered, ever-changing and extremely complicated world. Despite recent economic trends, public health graduates are sought for many different career paths. More importantly, the intensity to serve and to make a difference continues unabated among young people and even seems to be increasing. Thus, public health remains a popular career choice.
Q: With graduation season upon us, what advice would you give as a commencement speaker addressing graduating public health majors?
I would congratulate them on their choice. The need for the perspective of population health with its emphasis on prevention and health promotion has never been greater. Public health, with its core focus on social justice and health equity, is even more necessary now for our nation and for our world. Public health professionals at every level and in so many different careers have the capacity to change our society for the better.
The obvious commitment of the new graduates to making a difference and to service should be applauded. They will help assure the conditions for achieving healthy communities. I would advise the graduates to persist in their goals and ideals, to find ways to better communicate what they do and why, and to work diligently to develop public and private partnerships to address health needs.
To learn more about the work of the Association of Schools of Public Health, visit http://www.asph.org.
Photo of graduates courtesy iStockphoto