There is a growing interest in public health education at the undergraduate level. In 2009, The Chronicle of Higher Education referred to public health as one of five college majors on the rise.1 New degrees, concentrations, minors, and courses have been added in public health and its related disciplines at a number of institutions of higher learning, including those without a history of graduate training in public health. Graduate-level training in public health has a long history of accreditation by the Council on Education for Public Health (CEPH), recognized by the U.S. Department of Education as the accreditation body for schools and programs of public health. However, CEPH does not provide guidance on what should be included in undergraduate training programs in public health, with the exception of programs located within accredited schools of public health.
As part of its Framing the Future: The Second 100 Years of Education for Public Health (hereafter, Framing the Future) initiative, the Association of Schools and Programs of Public Health (ASPPH) convened an expert panel to identify the critical component elements (CCEs) of an undergraduate major in public health. This work came on the heels of a joint ASPPH and Association of American Colleges and Universities (AAC&U) effort in 2011 that produced 34 learning outcomes in public health for all undergraduates, an initiative aimed at providing faculty, students, and administrative leaders in two- and four-year institutions a framework for helping produce educated citizens in public health.2,3 This article reviews the CCEs, their purpose, and limitations, and also discusses some of the challenges associated with public health education at the undergraduate level.
FORMATION OF AN EXPERT PANEL
The Undergraduate Public Health Education Expert Panel selected to guide creation of the CCEs represented a broad cross-section of public health experts from academia and the practice world (Figure). Importantly, the academic representatives included topic area experts from both CEPH-accredited schools and programs in public health and institutions without CEPH accreditation. The expert panel also included a representative from AAC&U and one from the American Association of State Colleges and Universities. The practice community was represented by membership organizations of working public health professionals and by individuals with experience working at the state and local level. CEPH was also represented. The expert panel was chaired by one of the authors (Wykoff) and staffed by another (Weist). The overarching Framing the Future task force, a body created by ASPPH that advises on undergraduate public health issues for the association, is chaired by the third author (Petersen).
Figure.
Members of the Undergraduate Public Health Education Expert Panel convened by the Association of Schools of Public Health to specify critical component elements of an undergraduate major in public health: 2012
CHARGE TO THE EXPERT PANEL
The expert panel was charged with identifying and defining CCEs for bachelor's degrees in public health that prepare students to enter the workforce and/or to pursue advanced studies in public health or other health professions. Implicit in this charge was the realization that while many individuals with undergraduate degrees in public health seek further education, others enter the job market. The leadership of the expert panel chose the term CCEs to clearly distinguish the product from competencies and courses and to focus on what the panel felt were truly the essential requirements for adequate undergraduate education and training in public health.
Early in the process, the panel recognized a number of issues that they would not be able to resolve within the scope of the charge. Rather than allowing these issues to inordinately delay their work, the panel identified several guiding principles:
The CCEs were understood to serve only as advisory recommendations. It would remain in the purview of CEPH, or other accreditation bodies, to determine if the CCEs could or should play a role in the accreditation of undergraduate programs in public health, should such accreditation occur in the future.
The CCEs were developed explicitly as broad, general statements. They do not require the teaching of any specific courses or the provision of detailed curricular content. The expert panel aimed for the CCEs to identify essential features (i.e., the what) to allow individual schools and programs flexibility in determining the means of delivering those essential features (i.e., the how).
It was understood that the CCEs would call for certain critical components that might be fulfilled through the general education requirements of the host university and, therefore, would not have to be provided separately as a part of the public health educational component.
Perhaps most importantly, it was understood that the CCEs would not be able to address many unresolved issues related to undergraduate public health education. For example, the CCEs are silent on if/how an undergraduate degree in public health should articulate with a master's degree of public health. Additionally, the CCEs do not address the important issue of faculty qualifications. Finally, the CCEs neither require nor prevent an individual institution from having concentrations within an undergraduate degree program in public health.
Following direct meetings, webinars, and extensive public input, ASPPH released the Recommended Critical Component Elements of an Undergraduate Major in Public Health on August 3, 2012.
RECOMMENDED CCES OF AN UNDERGRADUATE MAJOR IN PUBLIC HEALTH
Following are the four recommended CCEs of an undergraduate major in public health, along with specific areas on which undergraduate students should focus.
Background domains
Students should be proficient in the following content areas:
Science. Students should have an introduction to the foundations of scientific knowledge, including the biological and life sciences and the concepts of health and disease.
Social and behavioral sciences. Students should have an introduction to the foundations of social and behavioral sciences.
Math/quantitative reasoning. Students should have an introduction to basic statistics.
Humanities/fine arts. Students should have an introduction to the humanities/fine arts.
Skill areas on which students should focus include:
Communications. Students should be able to communicate in both oral and written forms and through a variety of media to diverse audiences.
Information literacy. Students should be able to locate, use, evaluate, and synthesize information.
Public health domains
Undergraduate students should be introduced to the following public health domains through their studies:
Overview of public health. Students should have an introduction to the history and philosophy of public health, as well as its core values, concepts, and functions across the globe and in society.
Role and importance of data in public health. Students should have an introduction to the basic concepts, methods, and tools of public health data collection, use, and analysis and why evidence-based approaches are an essential part of public health practice.
Identifying and addressing population health challenges. Students should have an introduction to the concepts of population health and the basic processes, approaches, and interventions that identify and address the major health-related needs and concerns of populations.
Human health. Students should have an introduction to the underlying science of human health and disease, including opportunities for promoting and protecting health across the life course.
Determinants of health. Students should have an introduction to the socioeconomic, behavioral, biological, environmental, and other factors that impact human health and contribute to health disparities.
Project implementation. Students should have an introduction to the fundamental concepts and features of project implementation, including planning, assessment, and evaluation.
Overview of the health system. Students should have an introduction to the fundamental characteristics and organizational structures of the U.S. health system, as well as to the differences in systems in other countries.
Health policy, law, ethics, and economics. Students should have an introduction to basic concepts of legal, ethical, economic, and regulatory dimensions of health care and public health policy, and the roles, influences, and responsibilities of the different agencies and branches of government.
Health communication. Students should have an introduction to the basic concepts of public health-specific communication, including technical and professional writing and the use of mass media and electronic technology.
Cumulative experience and field exposure
Students should have opportunities to integrate, apply, and synthesize knowledge through cumulative and experiential activities. Students should have a cumulative, integrative, and scholarly or applied experience or inquiry project that serves as a capstone to their educational experience. And, as an integral part of their education, students should be exposed to local-level public health professionals and/or agencies that engage in population health practice.
Cross-cutting areas
Students should be exposed to concepts and experiences necessary for success in the workplace, further education, and lifelong learning. These cross-cutting areas may include advocacy for the protection and promotion of the public's health at all levels of society; community dynamics; critical thinking and creativity; cultural contexts in which public health professionals work; ethical decision-making as related to the self and society; independent work and a personal work ethic; networking; organizational dynamics; professionalism; research methods; systems thinking; and teamwork and leadership.
Throughout the curriculum, students should have a wide range of instructional methods and experiences that provide exposure to a solid foundation of the diverse nature of public health practice. In addition, students should receive career and graduate school advising.
LIMITATIONS AND REMAINING ISSUES
A number of challenges persist, even after the release of the CCEs. As noted previously, while the CCEs identify what should be included in an undergraduate public health training program, they do not specify how this material should be taught. Accordingly, the following questions require continued exploration:
Should there be mandatory courses in the core areas of public health, as is required for CEPH-accredited Master of Public Health programs?
Are specific qualifications for faculty who teach public health at the undergraduate level necessary?
Should specific guidance be provided on whether a student with an undergraduate degree in public health should be granted advance standing or some other level of articulation if the student were to enroll in a graduate public health program?
Finally, in those schools that do not have a history of undergraduate training in public health, questions remain as to how local employers will view an undergraduate degree in public health, both on its own and in relation to those potential employees with higher levels of training.
While many of these issues will have to be addressed, it is hoped that the CCEs will provide appropriate and useful guidance for both new and existing programs that offer public health training at the undergraduate level.4
REFERENCES
- 1.Fischer K, Glenn D. Five college majors on the rise. The Chronicle of Higher Education. 2009. Aug 31, [cited 2012 Oct 18]. Available from: URL: http://chronicle.com/article/5-College-Majors-On-the-Rise/48207.
- 2.Petersen DJ, Albertine S, Plepys CM, Calhoun JG. Developing an educated citizenry: the Undergraduate Public Health Learning Outcomes Project. Public Health Rep. 2013;128 doi: 10.1177/003335491312800517. to come. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 3.Albertine S, Petersen DJ, Plepys C. For the professional and for all: toward liberal education in public health. Peer Review. 2012;14:24–7. [Google Scholar]
- 4.Association of Schools of Public Health. FAQs on the critical component elements. [cited 2012 Oct 18]. Available from: URL: http://www.asph.org/document.cfm?page51209.