Students of public health must develop a range of skills and knowledge and an orientation focused on reducing inequities if they are to successfully tackle today's complex health challenges, said Dr. Jon K. Andrus, Deputy Director of the Pan American Health Organization...
Students of public health must develop a range of skills and knowledge and an orientation focused on reducing inequities if they are to successfully tackle today's complex health challenges, said Dr. Jon K. Andrus, Deputy Director of the Pan American Health Organization/World Health Organization (PAHO/WHO), during a Dec. 4 town hall discussion on the future of public health education at the George Washington University School of Public Health and Health Services in Washington, D.C.
"Historically, public health in the Americas and schools of health, both public and private, have been the voice for the right to health and Health for All, the defense of marginalized groups and communities, and the promotion of inclusive social and economic policies, based on the values of social justice and equity," Andrus told the audience of students, professors, and public health experts gathered for the event. "It will be critical to sustain that role in tackling emerging, more complex problems, well into the future."
Andrus noted that public health measures such as safe water and sanitation and control of vaccine-preventable diseases have brought dramatic increases in life expectancy. Longer lives have been accompanied by a dramatic rise in noncommunicable diseases, however, infectious diseases continue to have a significant impact, especially on marginalized and underserved population groups. These conditions require a new set of skills for public health practitioners.
"The social determinants of health—such as poverty, gender, education, ethnicity, geography, and access to health services—require an all-of-society approach and an approach to partnership and coordination that is often out of the traditional skill set of our public health professionals," said Andrus. "The adverse health consequences of the social determinants will require solutions outside health. What I call a more enlightened set of skills will be required for global health professionals if they are to lead."
For all students of public health, said Andrus, there is nothing more important than understanding epidemiology and the population approach to health. "Whether you work in communication, monitoring and evaluation, policy, program management, whether you are a nurse, sociologist, or behavorialist, you absolutely need to be well versed in the language of public health, which is epidemiology," said Andrus.
Future professionals also need to understand the use of evidence to ensure that public health interventions are effective. They must know "when is the evidence rock solid, when is it weak, when is it circumstantial?" said Andrus, adding: "Local public health departments lack the ability to manage and use the little evidence that exists. Efforts to conduct the necessary research to generate evidence are clearly lacking."
Equally important, public health professionals must have leadership skills that are grounded in what he termed the "three vs": values, vision, and valor. "The values of integrity and dedication, the vision to put those values into a practical strategic framework or plan going forward, and finally the valor or courage to fight and ensure that plans are acted upon," said Andrus.
He called on educators to serve as role models for future public health professionals and urged U.S.-based public health programs to look toward countries in Latin America—including Argentina, Chile, Ecuador, Nicaragua, and Peru, among others—for training models that prioritize community service, particularly in communities of poverty.
"I believe that education models that incorporate these fundamental elements of evidence, epidemiology, the leadership virtues of values, vision, and valor, the critical influence of role models and mentorship, and lastly and perhaps most importantly, experience, especially experience through service—these will help re-envision the education of our future public health professionals," Andrus concluded.
Other participants in the town hall event were Dr. Lynn Goldman, Dean of the George Washington University School of Public Health and Health Services; Dr. Howard Koh, U.S. Assistant Secretary of Health; Dr. Sarah Linde, Chief Public Health Officer at the Health Resources and Services Administration; Dr. Donna Petersen, Dean of the University of South Florida College of Public Health; and Dr. Rajiv Rimal, Professor and Chair of Prevention and Community Health in the George Washington University School of Public Health and Health Services.
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