Framing the Future: Provocative Questions

Welcome to the blog for "Framing the Future: The Second Hundred Years of Education for Public Health." We are setting a bold course to reassess, reconsider and reframe public health education for the current century. We need everyone's input to make sure we are as thoughtful, comprehensive and innovative as we can be. We will be posting a series of "provocative questions" designed to elicit input from a wide audience. As we are taking an "empty room" approach to this task, we begin with the first such question and encourage you to be free-thinking and forward-focused in your response. Any and all comments welcome! Stay tuned for new questions every couple of weeks. And thank you in advance for actively engaging in this exciting process.

Q1: What do you believe should be the essential elements of a newly designed public health education system in the 21st century United States?

Comments

[Lisa Simpson]

Dear Dean Petersen (a.k.a. Donna),

As the President and CEO of AcademyHealth, the professional society for health services and policy researchers, I was delighted to hear of this effort by ASPH and want to congratulate you on chairing such an important and prestigious panel!

In response to your question, let me propose three essential elements to get the conversation going. These are evidence, cross-sectoral approaches, and leadership.

1. Evidence - The critical need for more and better evidence to inform public health policies, strategies, and services is clear. Health services research, and especially public health services research, is an important component of that evidence base. Training public health professionals on the existing evidence base (and the gaps) as well as how to use evidence in decisionmaking at all levels will enhance the ability of the public health workforce to deploy resources for maximum impact.

2. Cross-sectoral approaches - The obesity epidemic is just the most recent public health challenge that requires us to think beyond labels and silos and work with a broad range of partners in the public and private sectors. Transportation, agriculture, housing, and education policies (among others) can support or impede our progress toward the HP 2020 goals. Perhaps "closer to home" for some public health professionals is the health CARE sector, where new opportunities and incentives are leading to a focus beyond individuals and a call for attention to population health. Training on these topics and policy domains will better prepare public health practitioners and leaders for the types of partners they will need to work with to be successful.

3. Leadership - Public health leadership training already exist, and should be expanded. Especially important are communication and negotiation skills, decisionmaking approaches, policy and advocacy expertise, and managing change.

AcademyHealth has identified public and population health as one of three priority areas for the development of new program and services in its new strategic plan. We look forward to supporting and informing the work of the Task Force!

Lisa Simpson
President and CEO
AcademyHealth
lisa.simpson@academyhealth.org
www.academy health.org

[Don Burke]

Donna,

An interesting and informative report on the early history of schools of public health was written by Thomas Parran and Livingston Farrand in 1939 entitled "Report to the Rockefeller Foundation on the Education of Public Health Personnel." At the time the Rockefeller Foundation was pursuing a strategy of geographic distribution of selected schools of public health across in the USA and Candada that could serve as regional centers of excellence. I was also especially interested in this report because its author Thomas Parran was US Surgeon General at the time, who then became our Pitt founding dean a few years later. The only copy of this report that I could find was in the Archives of the Rockefeller Foundation, which unfortunately has very strict copyright enforcement so I can't simply provide now it for posting alongside the Welch-Rose report. I'll contact the Archives to see if I can get permission to do so. A sound historical context will be helpful to these deliberations.
Regards, Don

[Stephen S. Davis]

Dear Discussants:

Our future should include a NATIONAL MEDICAL EDUCATION TEACHING ACADEMY.

My model is the military that, like us, use their technicians and professionals to be their school house and field teachers, but before they touch a student they are given a 4 week intensive teacher training school and then mentored for ~one year...and only then certified to teach the next generation.

We (current medical education administration), on the other hand, set an expectation for our medical educators to raise up the next generation and we give them exactly "0" hours of teacher training - the knowledge, skills, attitude and tools (for the most part) to do the job.

Thanks for the opportunity! ssd

[Charles R. Stack, M.P.H.]

Interesting discussion, thank you for initiating this! I am a DrPH candidate at the University of Illinois School of Public Health, where considerable time is spent on teaching us skills in "leadership." However, I believe that the future of public health education should focus upon fostering skills to build "followership!" In other words, working to educate the non-professional stakeholders so that they can make intelligent, well-informed policy decisions.

We enter the public health workplace as highly trained and motivated individuals, and yet, our public stakeholders, who typically have none of our skills, make our decisions for us through political processes, taxing authority etc..

Without our training, the public is prone to manipulation....witness how far the public's confidence in climate change has fallen due to the fallout from the famous "Climate Gate" email releases! Despite the seriousness of this public health issue, the public and politicians cannot run away from this issue quickly enough!! The threat is real, but the political will has evaporated nationally and globally.

Therefore, I suggest that the focus for public health education truly belongs at the earliest stages, for all citizens, rather than concentrated in the handful of professional SPH centers in the USA and abroad. The future will lie in introducing basic public health sciences including biostatistics and epidemiology to our youngest students, planting seeds that will grow and guide future policy.

Our present path is unsustainable, and discussing how to further polish the pubic health professional education system without fostering better public support is only a partial solution.

[Chad Swanson]

Hello, everyone. Thank you for this important and informative discussion.

I wanted to take this opportunity to suggest one additional background assumption that might need to be challenged in order to transform public health education; something like:

"Reductionist approaches - those that focus exclusively on one disease, project, policy, or program at a time - are inadequate to meet current and future public health challenges that are complex and dynamic. Systems stewards are needed to increase local capacity to identify and prioritize health needs and responses; identify and mobilize around high-leverage actions; minimize inefficiencies through duplications; maximize synergies between various actors; etc."

Best,

Chad Swanson, DO, MPH

[Stephen Wyatt]

As the agency responsible for ensuring quality in public health education, the Council on Education for Public Health (CEPH) considers the identification of essential elements to be critical. The Council considered the question posed by the Framing the Future Task Force at its winter meeting and offers the following Council member ideas on critical elements presented in the aggregate:

• Producing health professionals capable of 1) negotiating between multiple partners, 2) communicating to a variety of audiences and 3) mobilizing groups of people

• Ability to apply evidence-based methods to the assessment and improvement of the health of communities

• Global perspective, particularly related to sustainability and scalability

• Understanding of health equity and its various meanings, including social determinants of health and access to health care and health services

• Awareness of the importance of civic engagement at all levels, including the roles of individuals, communities and corporations

CEPH looks forward to continuing to engage in this process with our colleagues, which will also inform CEPH’s efforts to promulgate appropriate, relevant accreditation criteria in the coming years.

Stephen Wyatt, DMD, MPH
CEPH President

[Chad Swanson]

Dear Dean Peterson and others,

I assume that this movement's organizers are aware of the Lancet commissioned "Health professionals for a new century" report? (http://www.healthprofessionals21.org/)

If so, could you share your thoughts in a blog post?

Seems like there is quite a bit of room for shared learning and collaboration.

Best,

Chad.

[Darcy Scharff]

This might be an assumption as part of the capstone, but I would like to see something about opportunities (volunteer and otherwise) for students to work with faculty on their research.