The Future of Public Health Education
This Dean’s Note is co-written by Associate Dean for Education Lisa Sullivan.
Academic public health has grown significantly in recent decades, a change which has been echoed in the way public health is taught. Schools and programs of public health are reshaping their curricula to better reflect the evolution of the field and meet emerging public health challenges.
This week, the School of Public Health will host journalists, educators, and administrators for a Dean’s Symposium that will address the shifting landscape of academic public health. Titled “Teaching Public Health,” the event will be an opportunity to discuss the past and present of public health education, strategies for engaging students, fostering diversity and inclusion, teaching public health in nontraditional settings, and other topics. In advance of this event, we today run a Dean’s Note that synthesizes our prior reflections on the future of academic public health, to inform thinking about how we can create the next generation of public health professionals.
Schools of public health emerged to meet specific, pressing needs in society. In 1913, the Rockefeller Foundation convened a conference of public health leaders and foundation officials to discuss creating an educational framework that could produce a new class of public health professional. Schools linked to medicine, but with their own distinct, prevention-oriented identities, would form the basis for this profession, and the 1913 deliberations led to a report envisioning what these institutions could look like. The Welch-Rose report laid out a plan for a school centered around an “institute of hygiene,” where students would learn the areas of specialization necessary for a career in public health. Epidemiology, sanitary engineering, and hospital administration were just a few of the subjects recommended by the report. The report also advocated for an interdisciplinary approach to public health, suggesting an eclectic range of areas where a public health professional ought to be conversant.
More than 100 years later, the world’s public health needs have changed substantially, as have the determinants of those needs. Public health professionals today must contend with challenges in the production of population health—including global warming, population aging, urbanization, and environmental sustainability, to name but a few—that were barely on the radar of public health even two decades ago, never mind a century before. Moreover, as the world changes, its public health needs are growing—and there is a projected shortfall of nearly a quarter of a million public health workers by the year 2020.
It falls on us, then, as academic schools of public health, to ensure that we are preparing the public health workforce of the future, and ensuring they are equipped both to handle the public health challenges of today and to adapt to the public health challenges of the coming decades. In part responding to these observations, a national conversation around the nature of the MPH education has emerged over these past several years.
About a century after the release of the Welch-Rose report, the Association of Schools and Programs of Public Health (ASPPH) convened the Framing the Future Task Force to “re-vision the role of education for public health 100 years after the Welch-Rose Report.” The Framing the Future Task Force was convened to address a number of challenges, including: a growing interest in undergraduate courses, programs and degrees; an increase in DrPH programs, which vary widely in terms of their focus and goals, calling for more explicit articulation with the MPH; a shift to competency-based educational models; an increase in the number of accredited schools and programs in public health with new and different concentrations and sub-specializations to address changes in the field and the demands of the workforce; an expansion of the sectors in which public health professionals work (the majority of public health professionals now work outside of local public health); changes in educational technology and pedagogy; and increased focus on continuous quality improvement in educational programs to define, evaluate, and update curricula.
The task force’s report made a number of suggestions for how the 21st century MPH might be designed, including that “the common element of all MPH degrees should be a well-designed core that covers critical and interdisciplinary content in foundational areas of public health.” The report also called for in-depth, skills-based training in traditional and emerging specialty areas that meet the needs of employers, and the incorporation of population health into other professional degree programs.
Centrally, then, the aim of a 21st century school of public health is to produce professionals whose knowledge is broad, interdisciplinary, and grounded in deep, specialized study of the conditions that shape the health of populations. In keeping with these goals, our vision for graduate public health education is built on three key principles: 1. Public health education is relevant, authentic, and practical, 2. Public health education is inclusive, and 3. Public health education is ongoing. This approach, building on the work of the Framing the Future Task Force, came together in SPH’s redesigned MPH in 2016, structuring it around a new Core Curriculum, offering Interdisciplinary Graduate Certificates to equip our students for professional practice, and an Integrated Learning Experience that helps our students marry core content about the foundations of public health with a preparation for practice in the field right from the first day of their education
By combining breadth and depth in this way, our new curriculum could be described as “going diagonal,” to borrow a phrase used to describe the combination of “horizontal” and “vertical” approaches to building health systems. Going diagonal blends the general with the specific, the broad foundation with rigorous specialization, to create the best possible public health practitioners, who can, in turn, create the healthiest possible populations. We have since also introduced a lifelong learning initiative with our Population Health Exchange, allowing alumni and friends of the school to continue building their professional portfolios; and a new executive MPH program for public health professionals looking to bring an evidence-based approach to addressing population health concerns. All of these programs are meant to prepare students not only for how public health is currently practiced, but for how it will likely be practiced in the future, based on emerging trends.
This work of continually refining our programs to meet the demands of the moment is just one piece of the larger story of the future of public health education. As schools of public health are a relatively recent innovation in the US, public health training and curricula are still in a state of evolution, as schools work to offer degrees that are ever-better suited to the demands of the field. Substantial shifts in pedagogic focus, meantime—from teaching to learning, from discipline-specific courses to more integrated programs, from classroom study to in-the-field mastery of competencies, and from memorization to application—have created an opportunity for the academic public health community to create educational programs that are more dynamic and responsive to the world’s needs. And amid the uncertainties of our current political moment, academic public health is uniquely tasked with taking the steps necessary to make sure that our work is more clearly and widely accessible—to assert ourselves more directly into the broader political, cultural, and economic conversation.
But despite these shifting sands, a hundred years on from the original convening around the role of academic public health, our collective goal as public health educators remains unchanged: to provide students with an education that positions them to thrive in, and shape, the changing world in which their careers will unfold.
We hope everyone has a terrific week. Until next week.
Lisa Sullivan, PhD
Associate Dean for Education and Professor
Boston University School of Public Health
Sandro Galea, MD, DrPH
Dean and Professor, Boston University School of Public Health
Acknowledgement: We are grateful to Eric DelGizzo for his contributions to this Dean’s Note,and to the work of the many members of the BU community who contributed to the evolution of the BU MPH.