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Should Public Health Literacy Be a Core Requirement for College Students?

Maddock, Jay E. PhD; Moore, Justin B. PhD, MS, FACSM

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Journal of Public Health Management and Practice: July/August 2020 - Volume 26 - Issue 4 - p 304-305
doi: 10.1097/PHH.0000000000001187
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The novel coronavirus pandemic has illuminated many of the vulnerabilities in our public health and health care systems. While the lack of preparation and coordination has been stunning in many instances, one of the most troubling aspects has been a lack of knowledge in the general population about pandemics, how diseases spread, and how to minimize populations at risk. While this is troubling, it should not be surprising. Across the United States, it is highly unlikely that a student who attends school from kindergarten through university will get any formal education in public health except maybe the occasional person-centered topic covered in a health class. Across higher education in the United States, there are 63 schools of public health, 125 programs, and 16 stand-alone baccalaureate programs.1 There are more than 5000 universities in the United States and only about 200 offering an accredited public health program. In comparison, more than 4300 colleges and universities offer a degree in psychology.2 Even in those universities with a program, most students who are not public health majors or minors do not take a public health class. This leads to where we are today, with the vast majority of our population being public health illiterate.

The US government has recently passed a multi-trillion dollar package to aid individuals, communities, and corporations affected by the pandemic. While this is very important, efforts to eliminate or minimize future pandemics may be even more important. These efforts include increased ability to forecast and recognize novel viruses, rapid methods for testing, and accelerated vaccine production. In addition, we need to consider creating a public health–literate population. Public health touches numerous fields including engineering, architecture, agriculture, business, law, political science, international affairs, other health sciences, and many other disciplines. Over the last decade, the number of undergraduate public health programs has expanded rapidly. Students have also been drawn to these programs in record numbers, with many universities capping out admissions due to rapid growth. However, public health is still seen as a noncore discipline.

The majority of required core courses in the college curriculum focus on singular disciplines such as English, mathematics, psychology, foreign languages, and physics. While these are all important subjects, they don't bring together the interdisciplinary thinking the way that public health does. An introduction to public health course includes many important topics besides the spread of infectious disease.3 First, it focuses on thinking in populations. This way of thinking is an important perspective for any educated person since most citizens in the United States tend to think on an individual-level basis. Second, it focuses on health disparities and the social determinants of health. The connection between health and education, housing, income, discrimination, access to care, and many other factors are well known in the general population and provide rationale and justification for social programs designed to mitigate the effects of these determinants. Statistical thinking is essential for things that many people encounter on a daily basis such as probability, relative risk, and effect size. Systems thinking and social ecological approaches bring in the complexity of solving complex problems using a multidisciplinary approach. For 3 credit hours, this is a large amount of new topics that can help students view the world through a public health lens throughout their careers.

Getting from our current status to universal teaching of public health will not be easy, but this pandemic may be the perfect time to introduce this idea. College presidents and provosts would need to embrace the idea of including this course in the core curriculum. Faculty from schools and programs of public health would need to train thousands of faculty at community colleges and universities throughout the country in how to teach introduction to public health. Academies could be set up across the country to train faculty to teach this course and provide state-of-the-art lectures and materials. The one area that will not be a problem is student demand. It is highly likely that student demand for public health courses will greatly exceed capacity next fall.

While much of today's population has received a rapid education in public health and will not soon forget social distancing and flattening the curve, it is important to remember that the majority of freshmen in college this year were born after the events of September 11, 2001, and have little to no experience with terrorism on US soil. The time to act is now because a better prepared population can help stop the next pandemic.

References

1. Council on Education in Public Health. Who we accredit. https://ceph.org/about/org-info/who-we-accredit/accredited. Accessed March 26, 2020.
2. American Psychological Association. Enrollment data. https://www.apa.org/ed/precollege/about/enrollment. Accessed March 26, 2020.
3. Shultz JM, Sullivan LM, Galea S. Public Health: An Introduction to the Science and Practice of Population Health. New York, NY: Springer Publishing; 2021.
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