Training the Next Generation of Public Health Professionals

During the past two years, we have faced unprecedented challenges—the COVID-19 pandemic, social unrest, environmental crisis, and economic struggles, just to name the most visible ones. Our ability to cope with uncertainty and rapid change has been tested, and the academic public health community has risen to the moment. Schools and programs of public health (SPPH) immediately pivoted to remote education, ensuring that learners continue their educational programs, while working tirelessly with their communities and health agencies to mitigate the pandemic. Amid these trying times, myriad new opportunities for human development have arisen.

COMPETENCIES FOR THE FUTURE

The pandemic and societal challenges are a good reminder that SPPH need to prepare students “for jobs that have not yet been created, and for technologies that have not yet been invented, to solve problems that have not yet been anticipated.”^1(p2) We are at a turning point whereby the academic sector is exploring and envisioning a new way to educate the current and future generations. The COVID-19 crisis may well change our world and our global outlook; it may also teach us about how education needs to change to be able to better prepare public health professionals for what the present and the future might hold.

Research from Plepys et al. shows a minority of graduates (17%) now work in traditional governmental public health,² but the pandemic has brought a revitalized view of the importance of governmental public health, so, with intentional actions and initiatives, this might change. But we also must prepare students for a broader range of employment options, such as the increasing opportunities in health care and private industry³ as well as foundations and nonprofit organizations. Similarly, we must prepare them for the different responsibilities these jobs may have and incorporate competencies drawn from related fields, such as management of resources and supply chains from business, combatting misinformation from communications,⁴ advocacy, journalism, and media management, among many others.

The next generation of the public health workforce will need to strengthen the evolving technical and scientific competencies in public health, but, also, it will be crucial for them to develop human competencies such as resilience, curiosity, communication, cultural agility, empathy, compassion, flexibility, and the ability to cope with failure and rejection.^5,6 Future employers will also be looking for skills in critical thinking, problem-solving, creativity, adaptability, collaboration, teamwork, emotional intelligence, self-regulation, digital technology, and comfort working with diverse populations.^1,7 SPPH will also need to continue to instill appreciation for the values of our field: appreciation of diversity, ethical practice, and intolerance for injustice and inequities.

REDUCING HEALTH INEQUITIES

The pandemic has highlighted many health inequities and the impacts of social determinants of health. In this issue of AJPH, seven students present thoughts on reducing health inequities in relation to pandemics. Their work reflects the need to amplify our efforts to reduce health inequities, with examples including global interconnectedness, community engagement, digital literacy, focus on vulnerable populations, and supporting the public health workforce.

Addressing the social determinants of health is at the core of public health practice and, therefore, also at the core of public health academia. The Association of Schools and Programs of Public Health (ASPPH) is focusing on critical initiatives to lead academic public health forward and support the next generation of public health professionals—always through the lenses of diversity, inclusivity, justice, and equity:

• Creating “equitable, quality education for achieving health equity and well-being for everyone, everywhere”⁸ in three areas: inclusive excellence through an antiracism lens, transformative educational models and pedagogy, and expanding the reach, visibility, and impact of the field of academic public health.

• Dismantling racism and structural racism in academic public health: Racism is a public health crisis that demands bold action on many fronts, including academic public health. A long history of cultural and structural racism, along with other forms of discrimination, have shaped schools and programs of public health. Major changes are needed to “dismantle the conditions that enable racism in academic public health institutions and empower all our faculty, staff, and students to succeed in the 21st century,” including development of antiracism competencies.^9(p3)

• Addressing climate change in four primary domains: education and training, research, policy and advocacy, and practice. Three cross-cutting domains—health equity, environmental justice, and social justice; partnerships for impact; and interprofessional and interdisciplinary collaborations—are also being examined within the context of the primary domains.¹⁰

• A holistic approach to education: As the pandemic highlighted, it is critical that all citizens understand the foundations and concepts of health, disease, and prevention; these public health concepts should be included as part of a liberal arts education.¹¹ Regardless of a graduate’s ultimate career destination, having the core knowledge, skills, and competencies will open career opportunities and better prepare people for positions in public health, health professions, and other fields. We must also identify approaches to introduce public health concepts into teaching for students in grades K through 12 and in community colleges. Finally, we must continue to provide training opportunities and resources for the public health and health professions workforce, and for related fields, to ensure the workforce has the knowledge and skills necessary to respond to new and evolving public health challenges.

• Global collaboration in an interconnected world: Academic public health needs to have a more powerful voice on global issues and continue to create opportunities for global collaboration between leaders, faculty, and students. The Global Network for Academic Public Health is an alliance of seven regional associations that represent schools and programs of public health around the world, with the goal of enhancing academic public health worldwide through mutual learning and collaborations between academic public health institutions globally to improve and protect the health of people and the planet.¹²

• Intersectoral and interprofessional collaboration: Addressing the social determinants of health is an issue that involves all health professions and many related fields, such as law, city planning, architecture, agriculture, transportation, and many others. It also requires collaboration between government, nonprofit organizations, and for-profit organizations. This type of intersectoral and interprofessional collaboration can be difficult because these fields often work in silos and are also trained in silos. A systems thinking approach is needed to address these challenging issues, both in work and academia. The social determinants of health should be part of all health professionals’ education, and education in other fields should include potential health impacts.

• Supporting pathways for a diverse workforce: SPPH have a strong focus on recruiting diverse applicants to build a diverse workforce. Between March 2020 and May 2021, applications to graduate-level public health degree programs increased by 40%, including increases in Black/African American and Hispanic/Latino applicants.¹³ The This Is Public Health campaign, which raises awareness about education and career options in public health, helps recruit diverse applicants for SPPH through student ambassadors, graduate fairs, partnerships, interprofessional activities, and other events for students.¹⁴

• Data for decision-making: Public health education research conducted by ASPPH and its members serves as a catalyst to answer key research questions on public health education, including exploring pathways to the public health workforce. A study of first-destination employment of 53 000 graduates from ASPPH-member SPPH from academic years 2015 to 2018 found that 73% were employed, with another 15% moving on to further education. The top employment sector for those with a bachelor’s degree was for-profit corporations (38%); for master’s degrees, health care (27%); and for doctoral degrees, academia (42%).² This type of research helps inform education programs to ensure they are providing the skills the public health workforce will need.

The excellent work presented by students in this issue demonstrates the value of public health education—both in the knowledge and skills the students have already developed and in the potential for them to advance the work of public health to continue to reduce inequities and improve health and well-being for all people. The losses because of the COVID-19 pandemic are many and profound. We must heed the lessons we have learned to ensure that we are prepared to respond to, and hopefully prevent, the crises of the future. This is our opportunity to rethink academic public health.