The Institute of Medicine (IOM) in its 2003 report, Who Will Keep the Public Healthy? Educating Public Health Professionals for the 21st Century, recommended, "[horizontal ellipsis]all undergraduates should have access to education in public health."1(p144) Reaching "all" undergraduates means providing curriculum in public health in more than 1,900 colleges and universities without schools or programs in public health.
Moreover, in 2003 when the IOM made its recommendation, the movement toward development of undergraduate public health education in institutions with schools or programs in public health was just beginning to gain momentum.2 In the last few years, it has become evident that undergraduates seek and appreciate public health approaches and public health courses. They rapidly understand the direct impact on their lives of efforts to address issues from AIDS and avian flu, to the impacts of aging and the costs of healthcare. Schools or programs in public health that have offered introductory courses in public health have consistently exceeded enrollment expectations.
The Association for Prevention, Teaching and Research (APTR) and the Association of Schools of Public Health (ASPH) have taken literally the IOM recommendation. Fortunately, their efforts to introduce public health into undergraduate education have coincided with the efforts of undergraduate institutions themselves through the Association of American Colleges and Universities to put forward a national program called Liberal Education and America's Promise (LEAP).3 The program outlines the goals and vision for general and liberal education and has provided a framework for building undergraduate public health education into the goal of producing an educated citizenry.
This editorial describes recent effort to define and implement introductory undergraduate curriculum. However, success in reaching more than 1,900 colleges and universities without schools or programs in public health will require the support and involvement of the public health practice community.
Consensus Conference on Undergraduate Public Health Education
Concurrent with the IOM report, APTR and the Association of Academic Health Centers convened a consortium of health professional organizations that called itself the Healthy People Curriculum Task Force. In addition to putting forward a curriculum framework for clinical prevention and population health as part of clinical education, the consortium soon recognized the importance of preprofessional education in population health. In early 2005, the Healthy People Curriculum Task Force obtained a Josiah Macy Jr. Foundation grant to support its activities and included in these efforts a Consensus Conference on Undergraduate Public Health Education.
APTR, ASPH, and the Council of Colleges of Arts and Sciences, the largest Arts and Sciences Deans' group, sponsored the Consensus Conference on Undergraduate Public Health Education. Three working groups including representatives of APTR, ASPH, and Council of Colleges of Arts and Sciences as well as the Healthy People Curriculum Task Force developed specific recommendations for operationalizing the IOM recommendations. These working groups recommended and the consensus conference endorsed the following:
Public Health 101: An introductory course in public health (Public Health 101) should be offered by all colleges and universities. The course should be organized using a "big picture" population health framework integrated into the goals of general and liberal education. The course should be structured to enable it to fulfill a social science distribution requirement.
Epidemiology 101: An introductory course in epidemiology (Epidemiology 101) should be offered by all colleges and universities. It should be organized using a curriculum framework designed to achieve critical thinking as part of the goals of general and liberal education. The course should be structured to enable it to fulfill a science distribution requirement.
Minors and administrative issues: High-quality coordinated minors in public health should be encouraged for institutions with and without schools or programs in public health. Minor in Public Health should require Public Health 101, Epidemiology 101, and a focus area such as global health.
Methods for integrating the recommendations of the consensus conference into the nation's long-term strategy for public health were endorsed including:
* Web sites should be developed to provide information on undergraduate public health and to share curriculum materials.
* Faculty development efforts should assist colleges and universities in developing new introductory public health courses.
The full recommendations of the consensus conference will be reported in a supplement to the Morbidity and Mortality Weekly Report.4
Implementing the Consensus Conference Recommendations
Through support of the Josiah Macy Jr Foundation grant, APTR has developed the Prevention Education Resource Center that is providing organized curriculum materials using the curriculum frameworks for Public Health 101 and Epidemiology 101 included in the draft reports of the consensus conference.5
The Innovations in Public Health Education project, through the CDC-APTR Cooperative agreement, has funded 13 institutions to develop, teach, and evaluate Public Health 101 and/or Epidemiology 101. The syllabi used in these courses are available as part of the Undergraduate/Introductory Public Health section of the Prevention Education Resource Center.
In addition, APTR in collaboration with the Association of American Colleges and Universities is developing a pilot faculty development program to assist selected colleges and universities that plan to offer undergraduate public health courses. It is hoped that this pilot effort funded through the CDC-APTR cooperative agreement will be expanded in future years to meet the needs of full-time faculty as well as adjunct faculty including public health practitioners who participate in teaching undergraduate public health.
Colleges and universities need and increasingly seek the assistance of public health practitioners in introducing students to public health. Undergraduates introduced to public health are more likely to pursue careers in public health and to understand public health efforts.
An educated citizenry that understands public health approaches is the best guarantee of future support for public health. The current interest in undergraduate public health from colleges and universities without schools or programs in public health and from undergraduates themselves provides a unique opportunity to secure the future of public health. There is lots of work to do to take advantage of these opportunities. The enthusiasm and commitment of the current generation of undergraduates makes this an exciting, intellectually stimulating, and rewarding undertaking.
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