The Landscape of US Undergraduate Public Health Education

Historically, education in public health in the United States has occurred at the graduate level. Although some undergraduate programs in public health were established in the 20th century, more undergraduate programs have emerged in the past decade.¹ The growth of undergraduate education in public health aligns with the 2003 Institute of Medicine report by Gebbie et al² that called for all undergraduate students to have access to public health education. Other initiatives to advance undergraduate education in public health soon followed the Institute of Medicine’s call, including the educated citizen and public health initiative (2006),³ which provided resources for undergraduate faculty to integrate public health perspectives and concepts across a liberal arts educational framework; the undergraduate public health learning outcomes model (2011),⁴ which identified core public health knowledge and skill-learning outcomes for an undergraduate major in public health; and the recommended critical component elements of an undergraduate major in public health (2012).⁵

Furthermore, in 2003, the Council on Education for Public Health (CEPH), the accrediting body for schools and programs of public health, initiated accreditation of undergraduate public health programs to promote consistency and quality in curriculum content and academic infrastructure.⁶ In 2003, undergraduate programs in accredited schools of public health became eligible to apply for accreditation. In 2008, undergraduate programs affiliated with accredited master of public health programs became eligible to apply for accreditation. In 2013, eligibility for undergraduate accreditation was expanded to include stand-alone undergraduate public health programs.⁶

When examining the growth in undergraduate public health education and its potential implications, it is important to recognize distinctions between undergraduate and graduate education. These distinctions are particularly relevant to public health, because public health postsecondary education was initiated at the graduate level in the early 20th century, primarily for health care providers. Only in the early 21st century, after the Institute of Medicine called for broader access to public health education,² was public health education expanded to a broader audience at the undergraduate level beyond its initial base of a few institutions.⁷ For many other disciplines, postsecondary education originated at the undergraduate level and then advanced to the graduate level. As a result of the relatively recent prominence of public health education at the undergraduate level, some health professionals are likely unfamiliar with the undergraduate public health degree. Thus, the need for greater awareness and understanding of undergraduate programs should be considered when assessing possible implications of the growing phenomenon of undergraduate public health education.

Undergraduate education typically aims for students to recognize and gain a basic understanding of the underlying concepts in a selected discipline. A bachelor’s degree also provides foundational skills, introduces students to possible career trajectories, and prepares them for graduate studies or professional training, if warranted. In contrast, education at the graduate level typically hones in on specialized higher-level skill sets, often in more narrowly defined areas within larger disciplines (eg, epidemiology). These undergraduate and master’s degree distinctions are demonstrated in the CEPH accreditation criteria for undergraduate and master’s programs in public health. The accreditation core content areas for the undergraduate and master’s degrees focus on similar content areas, although graduate students are expected to grasp the content at a deeper level. Undergraduate public health students are expected to demonstrate 2 foundational competencies (communicate and use information), whereas master’s-level students are expected to demonstrate 22 competencies⁸ (Boxes 1 and 2).

Box 1.

Council on Education for Public Health accreditation criteria for undergraduate degrees in public health at schools and programs of public health, United States, 2016^a

Overall Curriculum Domains

1. Foundations of scientific knowledge, including the biological and life sciences and the concepts of health and disease

2. Foundations of social and behavioral sciences

3. Basic statistics

4. Humanities/fine arts

Foundational Domains

1. The history and philosophy of public health as well as its core values, concepts, and functions across the globe and in society

2. 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

3. 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

4. The underlying science of human health and disease, including opportunities for promoting and protecting health across the life course

5. The socioeconomic, behavioral, biological, environmental, and other factors that impact human health and contribute to health disparities

6. The fundamental concepts and features of project implementation, including planning, assessment, and evaluation

7. The fundamental characteristics and organizational structures of the US health system as well as the differences between systems in other countries

8. 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

9. Basic concepts of public health–specific communication, including technical and professional writing and the use of mass media and electronic technology

Foundational Competencies

1. The ability to communicate public health information, in both oral and written forms, through a variety of media and to diverse audiences

2. The ability to locate, use, evaluate, and synthesize public health information

Cross-Cutting Concepts and Experiences

1. Advocacy for protection and promotion of the public’s health at all levels of society

2. Community dynamics

3. Critical thinking and creativity

4. Cultural contexts in which public health professionals work

5. Ethical decision making as related to self and society

6. Independent work and a personal work ethic

7. Networking

8. Organizational dynamics

9. Professionalism

10. Research methods

11. Systems thinking

12. Teamwork and leadership

Box 2.

Council on Education for Public Health accreditation criteria for graduate degrees in public health at schools and programs of public health, United States, 2016^a

Foundational Public Health Knowledge

 Profession and Science of Public Health

1. Explain public health history, philosophy, and values.

2. Identify the core functions of public health and the 10 Essential Services.

3. Explain the role of quantitative and qualitative methods and sciences in describing and assessing a population’s health.

4. List major causes and trends of morbidity and mortality in the United States or another community relevant to the school or program.

5. Discuss the science of primary, secondary, and tertiary prevention in population health, including health promotion, screening, etc.

6. Explain the critical importance of evidence in advancing public health knowledge.

 Factors Related to Human Health

• 7. Explain effects of environmental factors on a population’s health.

• 8. Explain biological and genetic factors that affect a population’s health.

• 9. Explain behavioral and psychological factors that affect a population’s health.

• 10. Explain the social, political, and economic determinants of health and how they contribute to population health and health inequities.

• 11. Explain how globalization affects global burdens of disease.

• 12. Explain an ecological perspective on the connections among human health, animal health, and ecosystem health (eg, one health).

Foundational Competencies

 Evidence-Based Approaches to Public Health

1. Apply epidemiological methods to the breadth of settings and situations in public health practice.

2. Select quantitative and qualitative data-collection methods appropriate for a given public health context.

3. Analyze quantitative and qualitative data using biostatistics, informatics, computer-based programming, and software, as appropriate.

4. Interpret results of data analysis for public health research, policy, or practice.

 Public Health and Health Care Systems

• 5. Compare the organization, structure, and function of health care, public health, and regulatory systems across national and international settings.

• 6. Discuss the means by which structural bias, social inequities, and racism undermine health and create challenges to achieving health equity at organizational, community, and societal levels.

 Planning and Management to Promote Health

• 7. Assess population needs, assets, and capacities that affect communities’ health.

• 8. Apply awareness of cultural values and practices to the design or implementation of public health policies or programs.

• 9. Design a population-based policy, program, project, or intervention.

• 10. Explain basic principles and tools of budget and resource management.

• 11. Select methods to evaluate public health programs.

 Policy in Public Health

• 12. Discuss multiple dimensions of the policy-making process, including the roles of ethics and evidence.

• 13. Propose strategies to identify stakeholders and build coalitions and partnerships for influencing public health outcomes.

• 14. Advocate for political, social, or economic policies and programs that will improve health in diverse populations.

• 15. Evaluate policies for their impact on public health and health equity.

 Leadership

• 16. Apply principles of leadership, governance, and management, which include creating a vision, empowering others, fostering collaboration, and guiding decision making.

• 17. Apply negotiation and mediation skills to address organizational or community challenges.

 Communication

• 18. Select communication strategies for different audiences and sectors.

• 19. Communicate audience-appropriate public health content, both in writing and through oral presentation.

• 20. Describe the importance of cultural competence in communicating public health content.

 Interprofessional Practice

• 21. Perform effectively on interprofessional teams.

 Systems Thinking

• 22.Apply systems-thinking tools to a public health issue.

 Additional Competencies for Concentration or Generalist Degree

 The school or program defines at least 5 distinct competencies for each concentration or generalist degree in addition to those listed above.

In addition, when considering the impact of growth in undergraduate public health education, it is important to consider the increase in the number of undergraduate public health degree conferrals, the resultant growth in public health minors, and the increase in the number of students taking general education or elective courses in public health (eg, introduction to public health, global health, health behavior, environmental health, and health policy). This array of undergraduate educational offerings provides opportunities to integrate public health concepts and knowledge into undergraduate education for a large, diverse undergraduate audience across a range of potential career trajectories.

Furthermore, partnerships between undergraduate institutions and community colleges could expand access to public health education. An example of such a partnership is highlighted in a report on community colleges and public health by the Association of Schools and Programs of Public Health (ASPPH)/League for Innovation in the Community College.⁹ This report recommended foundational or core courses at community colleges, including “Personal Health: A Population Perspective,” “Overview of Public Health,” and “Health Communications.” These courses would ideally become foundational courses to prepare students for a range of health professions degree programs. This report led to collaborations among the League for Innovation in the Community College, ASPPH, and other organizations, including the ASPPH Undergraduate Public Health and Global Health Educational Network and the Society for Public Health Education. These collaborations have the potential to recruit a more diverse student body to study public health, which, in turn, could diversify the ranks of future public health professionals.

The present study builds on previous work by ASPPH and others^1,10,11 to examine the growth in undergraduate education in public health and assess its potential implications on the public health field. Our objectives were to (1) enumerate the degrees offered and the institutions offering the degrees and (2) explain quantitative trends in the number, geography, and diversity of graduates, including available data on career trajectories.

Methods

We used publicly available data from the National Center for Education Statistics (NCES), CEPH, and academic institution websites in this analysis. The NCES Integrated Postsecondary Education Data System (IPEDS)¹² and College Navigator database¹³ are publicly available data sets that include data on characteristics, degree offerings, and graduation rates of academic institutions. Because federal regulations require US undergraduate institutions participating in federal financial aid programs to submit degree conferral data to IPEDS, the IPEDS data set of institutions is considered complete.¹² College Navigator is NCES’s searchable database of postsecondary academic offerings across the United States.

We compared data from the College Navigator database with IPEDS data on degree conferrals to assess consistency between the data sets and identify trends in undergraduate public health education. We extracted IPEDS data on public health undergraduate degree conferrals from 2003 through 2016. Institutions reported undergraduate degrees by using the NCES Classification of Instructional Programs (CIP) coding framework.¹⁴ We tracked degrees in public health (51.22), epidemiology (26.1309), health policy analysis (44.0503), and biostatistics (26.1102) and assessed the distribution of public health undergraduate conferrals from 2003 through 2016 by race (non-Hispanic white, non-Hispanic black, Hispanic, or Asian/Pacific Islander), sex (male or female), and geography. We defined geographic regions by using the IPEDS methodology¹⁵ as follows: Southeast: Alabama, Arkansas, Florida, Kentucky, Louisiana, Mississippi, North Carolina, South Carolina, and Tennessee; Far West: Arkansas, California, Hawaii, Oregon, and Washington; mid-Atlantic: Delaware, District of Columbia, Maryland, New Jersey, New York, and Pennsylvania; Great Lakes: Illinois, Indiana, Michigan, Ohio, and Wisconsin; Southwest: Arizona, New Mexico, Oklahoma, and Texas; Rocky Mountains: Colorado, Idaho, Montana, Utah, and Wyoming; New England: Connecticut, Maine, New Hampshire, Rhode Island, and Vermont; and Plains: Iowa, Kansas, Minnesota, Missouri, Nebraska, North Dakota, and South Dakota.

We reviewed websites of the 296 institutions reporting undergraduate degree conferrals in public health as annual IPEDS reporting data became available in the summers of 2015 (when 2014 data were released), 2016 (when 2015 data were released), and 2017 (when 2016 data were released). We used information from institutions’ websites to verify and categorize their undergraduate public health degree offerings (bachelor of science or bachelor of arts) and content areas (exercise science/kinesiology/athletic training; health services administration; health promotion/health education; public health/community health; nutrition; health science; and environmental health). Because of uncertain and incomplete information on the websites of some institutions and the time lag in the release of IPEDS data, we organized our findings as general themes rather than quantifiable results.

We conducted data management and analysis using Stata version 15,¹⁶ and we visualized data using ArcGIS version 10.4.¹⁷

Results

A total of 75 165 undergraduate public health degrees from 271 institutions were conferred during 2003-2016, increasing from 1448 in 2003 to 12 895 in 2016. More than half of the undergraduate public health degrees were conferred from 2011 through 2016.

Geographic Distribution

Of the 12 895 undergraduate public health degrees conferred in 2016, most were from institutions in the Southeast and West, and the fewest degrees conferred were from institutions in New England and the Plains states (Figure). The 5 states with the most colleges and universities conferring undergraduate public health degrees in 2016 were California (20 institutions, 1699 degrees), Florida (11 institutions, 775 degrees), North Carolina (16 institutions, 687 degrees), Oregon (5 institutions, 615 degrees), and Utah (7 institutions, 575 degrees).

Figure.

Bachelor’s and master’s degree conferrals in public health, by region, United States, 2003-2016.

Degree Format

Of the 296 institutional websites reviewed, 281 (95%) offered the bachelor of science degree, including the bachelor of science in public health or bachelor of health science, and 15 (5%) offered the option for a bachelor of arts degree. Fifteen (5%) of the reviewed institutions offered only a bachelor of arts degree in public health. All of the reviewed institutions offered an undergraduate public health degree through on-campus courses; however, 3 of the reviewed institutions also offered the option of an online degree.

Student Demographic Characteristics

From 2003 to 2016, the proportion of women earning undergraduate degrees in public health increased from 73% to 78%, the proportion of Asian/Pacific Islanders increased from 5% to 13%, and the proportion of Hispanic students increased from 6% to 14%. Conversely, from 2003 to 2016, the proportion of non-Hispanic white students among all public health undergraduates decreased from 62% to 50% and of non-Hispanic black students decreased from 23% to 16%. In comparison, of all students earning any undergraduate degree in 2014 in the United States (n = 1.9 million), 67% were women, 68% were non-Hispanic white, 10% were non-Hispanic black, 10% were Asian/Pacific Islander, and 9% were Hispanic.

Academic Areas of Study

According to IPEDS, the most frequently conferred undergraduate public health degrees during 2003-2016 were in public health education and promotion (CIP code 51.2207, n = 20 753), public health–general (CIP code 51.2201, n = 20 366), and community health and preventive medicine (CIP code 51.2208, n = 11 299). From 2010 to 2015, the largest increases in degree conferrals reported were in public health–general and occupational health and industrial hygiene.

Public health majors were offered in a wide range of public health-related disciplines, and many institutions offered more than one type of public health major and/or concentration area within a public health major. Some programs also offered a public health minor. The undergraduate majors most often offered were characterized as follows: exercise science/kinesiology/athletic training, health services administration, health promotion/health education, public health/community health, nutrition, health science, and environmental health.

Public health degrees were most often offered by programs housed in colleges or schools of health professions or health science and in colleges of arts and sciences. A small number of public health degree programs were offered by other types of colleges, including education, business, agriculture, nursing, and medicine.

A wide range of academic departments offered undergraduate public health degrees. Although the academic departments were wide ranging and difficult to characterize, they were grouped around the following general themes: public health/health policy and management/health administration, kinesiology/human performance/physiology/athletic training/physical education/exercise or sport science, health education, health systems/health information, food science/nutrition/dietetics, behavioral health/allied health sciences, family and consumer/community health, biological health sciences, and occupational and environmental health/environmental sciences/sustainability.

Institutions

The number of institutions offering undergraduate public health degrees increased during the study period. In 2003, 83 institutions reported undergraduate public health degree conferrals, with a mean of 17 degree conferrals per institution (maximum, 120). In 2016, 271 institutions reported undergraduate public health degree conferrals, with a mean of 48 degree conferrals per institution (maximum, 536; Table).

Table.

Number of undergraduate public health degrees conferred and number of institutions, by year, United States, 2003-2016^a

Year	No. of Institutions Awarding Degrees	Total No. of Degrees Awarded by All Institutions	Mean No. of Degrees Awarded per Institution	Median No. of Degrees Awarded per Institution	Maximum No. of Degrees Awarded by One Institution
2003	83	1372	17	11	120
2004	93	1502	16	10	105
2005	101	1831	18	10	106
2006	111	2219	20	11	130
2007	125	2839	23	11	166
2008	135	3365	25	13	188
2009	135	3835	28	16	178
2010	143	4514	32	19	226
2011	162	5381	33	18	247
2012	179	6483	36	18	341
2013	198	8141	41	21	341
2014	224	9661	43	18	435
2015	245	10 988	45	20	558
2016	271	12 895	48	22	536

^a Data source: National Center for Education Statistics, Integrated Postsecondary Education Data System.¹²

In 2016, of the 12 895 undergraduate public health degrees conferred, 81% were from research universities offering up to a doctoral degree in any field or discipline, 13% were from colleges and universities offering up to a master’s degree in any field or discipline, and 6% were from colleges and universities offering up to a bachelor’s degree. In 2003, of the 1372 undergraduate public health degrees conferred, these proportions were 92%, 4%, and 4%, respectively.

In 2016, of the 271 institutions conferring undergraduate public health degrees, the 10 largest institutions (4% of all institutions) reported 2996 of the 12 895 (23%) undergraduate public health degrees. The 50 largest undergraduate public health programs (18% of institutions) conferred 8068 of the 12 895 (63%) undergraduate public health degrees. Also in 2016, public health programs graduating <10 students per year accounted for 27% of all institutions that awarded public health degrees, for a total of only 305 degrees (2% of total conferrals).

Of the 296 institutional websites reviewed, 154 (52%) institutions were public, 117 (40%) were private nonprofit, and 25 (8%) were private for-profit. For 26 institutions that reported public health degree conferrals to IPEDS, we found no major in public health or a public health-related major on the institution’s website (eg, the website indicated only a master’s degree in public health or a clinical major, such as nursing or physical therapy). These 26 institutions with no known public health-related major reported 236 undergraduate public health degrees conferred in 2016 to IPEDS; eliminating the degrees conferred from these 26 institutions reduced 2016 public health degree conferrals by 1.8%, to 12 659.

Trends and Growth in Program Development

Although larger institutions (>10 000 students) conferred most of the undergraduate public health degrees during 2003-2016, the number of degrees conferred by smaller institutions (<5000 students) increased from 2013 to 2016, as the number of stand-alone undergraduate public health degree programs in smaller institutions increased. Furthermore, 271 institutions reported undergraduate public health degree conferrals to IPEDS in 2016. However, in 2016, the NCES College Navigator database, which shows all undergraduate public health degree programs (not only degree conferrals), reported 319 institutions offering undergraduate public health degree programs, suggesting continued growth in undergraduate public health degree program development.

Discussion

Our analysis confirmed previous findings that undergraduate education in public health continues to grow and is now a mainstay of the public health education continuum.^1,7 An extensive, sustained, and increasing number of students have received undergraduate degrees in public health from an increasing number of academic institutions since 2003.

Another indicator that undergraduate education is now a mainstay of the public health education continuum is the growth in the number of accredited undergraduate programs. Accreditation was first made available to undergraduate programs housed in schools of public health in 2003, expanded to undergraduate programs housed with accredited master of public health programs in 2008, and made available to stand-alone undergraduate public health programs in 2013. As of March 2018, a total of 133 undergraduate programs in public health were CEPH accredited. These accredited undergraduate public health programs were offered by 81 institutions housed in 46 schools of public health, 27 programs of public health, and 8 stand-alone undergraduate programs. In 2016, degrees from accredited undergraduate programs accounted for 6834 of the 12 895 (53%) undergraduate public health degree conferrals.¹⁸

As of March 2018, 20 institutions had applications for accreditation of a public health undergraduate degree under review; 12 were from stand-alone undergraduate programs, and 8 were included as an undergraduate component of a public health program accreditation application.¹⁹

Because many public health workers have little to no formal training in public health,²⁰ the growth in undergraduate public health education could bolster the public health workforce. However, the growing number of undergraduate public health degree programs has raised concerns among educators and leaders in the field that graduates with an undergraduate public health degree will take positions away from graduates with master’s degrees in public health, for less money. To date, no evidence substantiates this concern. However, with continued growth of undergraduate public health programs and increasing numbers of graduates, along with an expansion into associate-level public health degrees, a clear articulation of the differences between all levels of postsecondary public health training is needed.

In addition, more short-term and long-term data are needed on public health career trajectories at all education levels (associate, bachelor’s, and master’s). The public health field has acknowledged this need and has begun to address it. In 2016, ASPPH initiated annual data collection from its member institutions on job outcomes at the undergraduate and graduate levels.²¹ In addition, the National Board of Public Health Examiners conducted a job task analysis in 2014 to identify public health job tasks across the 10 domains addressed in the Certified in Public Health (CPH) examination,²² which provides a foundation for a greater understanding of the tasks performed and public health knowledge and skills needed. Such advances could provide opportunities for systematic data collection and analysis to assess and evaluate the growing public health educational continuum and its potential impacts on the field.

Where Are Students Going After Graduation?

Data on postundergraduate trajectories are still emerging, but limited data indicate a mix of employment, graduate training, and other activities (eg, community service, fellowships, travel) in a range of disciplines.²³ ASPPH reported on more than 1300 bachelor’s degree graduates from its member institutions in 2014-2015 and found that more than 75% were employed and 12% were pursuing further education (13% did not respond). Of those employed, the largest proportion (34%) worked at for-profit institutions, nearly 20% at health care organizations, and 11% at governmental organizations (35% were working elsewhere or did not respond).²³ More data are needed to systematically track alumni career trends and immediate postgraduate trends; the most recent systematic study on public health graduates was conducted in the 1980s.²⁴

Informal reports to study investigators from undergraduate public health program administrators suggested that career trajectory patterns were aligned with income. Graduates of lesser means were more likely to advance directly to full-time employment, usually within close proximity to their hometowns, whereas graduates of greater means were more likely to participate in a range of activities both domestically and internationally, including employment, graduate education, or other (eg, fellowships, community service).

Diversity

Diversifying the public health workforce to ensure that it represents the population it aims to serve is a priority for the public health field.^25-30 Graduates from undergraduate public health programs are increasingly diverse, with 50% of undergraduate public health degree conferrals to nonwhite graduates in 2016 compared with 38% in 2003. Conversely, 32% of all undergraduates in the United States in 2014 were nonwhite.¹² Growth in the number of undergraduate public health programs, along with expansion of public health minors and general education courses, offer opportunities to broaden the reach of public health education to all postsecondary students and increase the diversity of the public health workforce. Furthermore, emerging efforts to expand public health education to community colleges, which now have a majority of minority students and include many students from low-income populations, offer additional opportunities to diversify the public health workforce. Lastly, the suggestion that undergraduates, particularly those from underserved communities, tend to work in close proximity to where they grew up supports the idea of introducing middle and high school students to public health as a postsecondary education and career opportunity.

Quality

Another key public health workforce priority is a competent workforce adequately trained to do the job.^27-31 The growth of CEPH-accredited undergraduate public health programs supports advancement of quality and consistency across the undergraduate programs. The uptake of CEPH accreditation at all types of postsecondary institutions appears to be growing but is still emerging and will likely evolve during the next few years. However, the cost and administrative requirements of accreditation should be assessed for smaller, underresourced undergraduate institutions. In addition, the feasibility of accreditation for associate degree public health programs needs to be assessed.

The aim of accreditation is to improve consistency and quality of education; however, further research is needed to assess the alignment of accreditation criteria with practice needs. This work has begun and, in 2016, CEPH revised the accreditation requirements away from a coursework framework to further emphasize practical knowledge and skills in alignment with public health workforce competencies.^32,33 However, more work is needed to delineate job tasks and competencies across the public health education continuum.

Continued Growth

The continued growth in undergraduate programs of public health shows no signs of slowing, and additional programs are anticipated. Similar fields in the health professions and related programs have a larger undergraduate-to-graduate ratio than the field of public health. The ratio of undergraduate-to-graduate degrees awarded in public health shifted from 1 undergraduate per 5 graduate conferrals in 2003 to 1 undergraduate per 1.4 graduate conferrals in 2015. In similar programs, such as health and medical administrative services (CIP code 51.07), the ratio is the inverse, with more undergraduate students than graduate students (mean, 2:1; median, 1.3:1).¹² Thus, the number of undergraduate degrees awarded will probably soon meet, and likely exceed, the number of graduate degrees awarded, thereby further emphasizing the need for articulating the differences between graduate and undergraduate degrees in public health and their respective roles within the public health workforce.

Interdisciplinary Approaches

Graduates with bachelor degrees in public health and those with some postsecondary public health education (eg, a minor or some general education courses in public health) offer opportunities to enhance population health across a broad trajectory, with professionals who have some public health training pursuing career trajectories both within public health directly and in other disciplines (eg, law, urban planning). Given the relatively recent emergence and continuing evolution of undergraduate education in public health, there is much room for growth in fostering such interdisciplinary opportunities. Building awareness of public health and public health curriculum links to undergraduate programs in an array of fields (eg, law, urban planning) is important to recognize and address public health issues within the traditionally defined realm of public health and in other disciplines that can affect population health (eg, finance, transportation). In this age of declining public resources and multifaceted public health problems, such interdisciplinary approaches are needed to ensure the protection and promotion of the public’s health.

Limitations

This study had several limitations. Because NCES data are self-reported, reporting inconsistencies across institutions were likely. In addition, no data were collected on public health minors or general education requirements. As such, the extent of growth in these educational areas is unknown. Furthermore, the website reviews were limited by the varying time periods in which they were conducted (during the summers of 2014-2017) as well as inconsistent information available on institutions’ websites. Lastly, any data coding or analysis errors committed by our study team may have resulted in inaccuracies. However, given the number of institutions in the study and the consistency of these findings with previous research, any inaccuracies in this work are unlikely to skew the overall study findings.

Conclusion

This study quantifies that undergraduate education is now a mainstay in the public health education continuum. Our findings highlight the need to conduct further research and articulate the differences in training at each level of postsecondary public health education. In addition, there is a need to raise awareness of and build diversity in the public health workforce, increase the number of public health professionals with formal training in public health, and foster interdisciplinary approaches to better protect the public’s health.