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Health and Illness in Context: A Pragmatic, Interdisciplinary Approach to Teaching and Learning Applied Public Health Within an Urban Safety Net System

Iles-Shih, Matthew MA; Sve, Chuck LAC; Solotaroff, Rachel MD; Bruno, Richard BS; Gregg, Jessica PhD, MD

Journal of Public Health Management and Practice: July/August 2011 - Volume 17 - Issue 4 - p 308–312
doi: 10.1097/PHH.0b013e31820f8e56
Original Article

Background: Academic centers and community programs are too often separated by institutional and cultural chasms. Such divides weaken our capacity to develop a diverse public health-oriented, community-based workforce. This article describes one bridge designed to connect the academy to local safety net systems and the lessons learned during its construction.

Program Description: Health & Illness in Context” is an interdisciplinary program developed in 2008 by students at Oregon Health & Science University and staff at Portland's Central City Concern. Over a 7-week period, small cohorts of medical, nursing, and public health students gain an intimate, street-level understanding of the local safety net and the structural forces that shape it. Guided by program faculty, they traverse the maze of urban social services—following clients' pathways from homelessness and addiction to treatment, recovery, and social reintegration. In each 4-hour session, students: (1) apply key concepts from public health to challenging real-world contexts, (2) explore effective, innovative approaches to addressing complex health and social issues, and (3) directly engage members of underserved communities and the diverse professionals that serve them.

Outcomes: Although too early to formally assess its impact on career choice, Health & Illness in Context is already serving as an incubator for novel public health-oriented experiences, curricula, and activism that are further narrowing the community-university divide. Citing Health & Illness in Context as a primary inspiration, students have developed complementary elective courses, community-outreach activities, and long-term community collaborations. Meanwhile, program faculty members, now formally advise student initiatives, serve as mentors/preceptors, and have expanded their involvement at the university.

This article describes the Health and Illness in Context program that acts as a bridge to connect the academy to local safety net systems and the lessons learned during its construction.

School of Medicine, Oregon Health & Science University (Messrs Iles-Shih and Bruno), Old Town Clinic, Central City Concern (Mr Sve and Dr Solotaroff), and Hooper Detoxification Center, Central City Concern (Dr Gregg), Portland.

Correspondence: Matthew Iles-Shih, MA, Public Health & Preventive Medicine, Oregon Health & Science University, 3181 SW Sam Jackson Park Road, Mail Code CB 669, Portland, OR 97239 (

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