March 26, 2015

COPH Dean Speaks on National Trends in Public Health Education

C O P H Dean James Raczynski P h D, F A H A

COPH Dean Jim Raczynski

Jim Raczynski, Ph.D., Professor and Founding Dean of the UAMS Fay W. Boozman College of Public Health (COPH), spoke at the Arkansas Department of Health Grand Rounds on March 19 about changes in academic public health nationally and impacts on public health practice. He spoke in particular about efforts on the national level to strengthen the doctor in public health (DrPH) degree as a cornerstone of professional public health education.

When the first school of public health in the United States was founded at Johns Hopkins University a century ago, public health education was envisioned as described in the Welch-Rose Report of 1915 as mainly for health officers, typically physicians and nurses already working in government public health agencies. Today, governmental agencies hire only a fraction of new public health graduates, who come from a variety of educational and work backgrounds. Academia, foundations and think tanks, non-profits, hospitals and other health care providers all employ those with public health degrees throughout the public and private sectors.

The number of schools and programs in public health – and the degree options and numbers of graduates in public health – have proliferated tremendously, particularly over the past few decades. Today, there are 160 schools and programs in public health with many others under development, and the degree choices, once limited to the master (MPH) or doctorate in public health (DrPH) now number in the dozens, from the bachelor to doctoral level, with many combined degree options in which students can earn the MPH and another professional degree, such as in medicine, nursing, pharmacy, law and communication science to name just a few. The UAMS COPH is part of that national trend, currently offering 25 degrees and certificates to meet a variety of workforce training needs and respond to student and employer interests.

Although there has been tremendous growth nationally across the range of certificate, master and doctoral programs, probably the greatest expansion has been at the undergraduate level. Undergraduate major programs in public health are being started by many universities and colleges with large enrollments, making these programs among the most popular majors in higher education. In response to this interest, some universities, including the COPH, have developed 4+1 programs that enable students to begin taking MPH courses while still undergraduates. By agreement with their institution, these courses also count toward the undergraduate degree. Students can complete their undergraduate degree in the normal four years, and then can complete the MPH degree, if they so choose, in a year or a little more, reducing the time to complete a separate master degree by about a year.

“’Population health’ is becoming a buzz word, as more people are becoming interested in public health,” commented Dr. Raczynski. “Public health is rapidly becoming the new most popular undergraduate liberal arts major, reflecting, I believe, the importance beginning to be placed by the public on prevention, preparedness and other important public health functions.”

As academic public health has evolved along with a plethora of degree offerings (with sometimes bewildering acronyms), national leaders are seeing the need to address variations in degree competencies and requirements, especially for the DrPH. Since 2007, Dr. Raczynski has been active in those national efforts.

“The competencies for the DrPH have varied considerably from school to school,” he said.

In 2009, a diverse group of public health academicians and practitioners convened by the Association of Schools of Public Health (now the Association of Schools and Programs of Public Health, ASPPH) and chaired by Dr. Raczynski produced DrPH competencies, serving as a non-prescriptive model for schools and programs of public health. Then in 2014, he led a DrPH Expert Panel of practitioners and academics formed by the ASPPH Framing the Future of the Public Health Education Task Force, which continues efforts to refine and support education for the DrPH and other public health degrees.

The goal is for the “DrPH to become a better, more respected degree with graduates capable of being transformative and translational leaders and advancing public health practice evidence of what works,” Dr. Raczynski said.

Out of ASPPH’s work has come a clearer vision for academic public health and the needed changes in academic programs to better meet public health practice needs. It is expected that the awareness of public health will continue to grow and that inter-professional, systems-level approaches to solving public health problems will too, fueled by ever more powerful computer and data analytic capabilities and the growing population-health focus developing in health care reform.

“Other health professions have woken up to the fact that there is more to improving health than can be realized in one-on-one patient interactions – focusing on the population and prevention are also essential,” Dr. Raczynski commented.

With this trend, public health as an inherently multi-disciplinary college major will continue to have wide application, and the popularity of the public health bachelor’s degree will likely continue to grow.

As for the DrPH, there is a lot on the horizon for those earning that degree. They will fill important leadership roles in both the academic and public health practice arenas, growing in value with the “increasing focus on population health outcomes and lower costs,” Dr. Raczynski said. “The DrPHs will be the transformative leaders with the expertise in evidence-based public health practice and research who are able to convene diverse partners, be effective change agents, and who can understand and generate practice-based evidence needed to solve public health problems of the future.”