VIEW: Why We Need Public Health Education

The U.S. has the most expensive healthcare and education system in the world, but is terrible at keeping people healthy and educated.

VIEW columns are made possible by MN Reconnect, a program designed for adult learners re-enrolling in college to help them complete their education.

Alexis Yeboah has a Masters of Public Health from the University of Minnesota and is a writer and healthcare consultant focused on whole-person care for Black communities.

It was recently reported that new coronavirus infections have fallen by 33 percent from early January. This is a huge win, given that the virus had claimed close to a half million American lives. However, we know that there was a botched initial vaccine rollout, with attempts by the Biden Administration to rectify the mess of his predecessor. We also know that mutated strains are barreling though the U.S., while citizens continue to suffer unbearable financial, mental, and physical strain.

We are still racing against the clock.  And will continue to do so. As climate change continues to accelerate, nature’s defense mechanisms — biodiversity, permafrost — will continue to disappear. Diseases that we once thought were eradicated, or only existed in animals, have a higher possibility to infect humans because of deforestation and development on wild land. 

If infectious diseases become more prevalent, as I believe they will, we need to have an even stronger public health system, with a more educated population. Having an understanding about how climate change and public health relate is vital for the future we are stepping into.

Why Now?

The COVID-19 fight during the past year was due in large part to the uphill battle of having to educate the population about basic public health concepts, leaving little time for crucial work on engagement.

Public health holds no prestige in our society. It is a discipline that is unseen, invisible by design. I believe it should be a mandatory component of education curriculum. It is far less costly to teach everyone about vital science from a young age, and continue to reiterate its importance, than it is trying to get adults to change what a belief system that is not always based on those facts.

The U.S. has the most expensive healthcare and education system in the world, but is terrible at keeping people healthy and educated.

The COVID briefings illustrate how poorly we as a country are taught about basic public health principles. Early in the pandemic, someone admitted on Instagram that they were not much of a hand-washer before the pandemic. I suspect this sentiment is shared by more people than those willing to say it out loud. How many of us, before digging into an office potluck, washed our hands? How many of us know why we do it — how microbial elements work?

The lack of trust in vaccines — including among some Black healthcare workers — and the impact of racism in healthcare that leads to a lack of trust, shows a fundamental lack of public health education.

From a young age we should implement age-appropriate public health education. We can talk about basic hand-washing and hygiene guidance, in addition to the general conversations about the dangers of smoking, abusing alcohol and drugs, speeding in a car, and warnings about unprotected sex. But we should also build on this: how public health was practiced in history, how it relates to historical and present-day pandemics. In social studies classes we can talk about how policies have led to disparities in health outcomes. Public health is a wide field with plenty of room for creativity.

  • Conversation about what it prevents if we had comprehensive and universal sick time in order to stay home when we are sick
  • A week spent every year on mental health awareness, including trainings and resources
  • Anti-racism workshops as a public health issue
  • How workplaces could provide a different model of health insurance, with more focus on prevention, and why access to fitness facilities and mental health should be part of that
  • What is healthy food, and what difference does it make?
  • How is climate change expected to increase the likelihood of pandemics?

Employers can also add to these conversations in adulthood. How do we create an environment where employees can practice healthy behaviors in a safe place? What happens when we don’t? How does that impact the bottom line?

How can they creatively offer access to the care employees need, through insurance and adequate pay, to be able to access healthy and safe food, housing, and medical care for themselves and their families. What is lost when we don’t provide those basics?

Public Health Needs to Be Visible

I think public health is invisible by design. When it is working well, we don’t see it. We don’t see the plans and regulations that are enacted to make sure we have access to health services. We don’t see public health investigators working on outbreaks. We don’t see how homes are evaluated and addressed for lead poisoning. Public health tends to be a behind-the-scenes field. 

I define crucial engagement work as understanding where people are coming from and how to talk to them. Listening to the barriers and perceptions they have on the front-end and not pandering to them when there is a problem. Meeting people where they are, where they work and live, and building authentic trust — not just extracting or berating.

Our lack in public health education even extends to higher education, for students studying the field. A report from 2010 highlighted how medical schools are still lacking public health courses for pre-med students. No wonder over 15 percent of healthcare workers and clinicians are declining the COVID vaccine.

Black people in particular distrust the health system. The Tuskegee Syphilis Study, for example, was an unethical health study that has deeper implications.

Minnesota has among the worst maternal health outcomes for Black mothers in the nation, and rank near the bottom of all health scales for Black people regardless of socio-economic status or education. The Black community is wary about medical interventions because healthcare and public health system have shown us they do not care about us.

We can change this. Here are three steps to start:

  • Public health must become part of required health and science curriculum for K-12 education. Much of our COVID misery during this past year could have been circumvented by the simple act of requiring public health education as a mandatory addition to schools in the U.S.
  • Medical and public health schools have to update their coursework and requirements to make sure clinical staff and public health professionals are trained for the modern realities they face. These include culturally responsive ways of health engagement, communication and how public health relates to patient-centered care. As a graduate student studying for my MPH, I had the choice to take courses with MBA and MHA students. I learned the business of healthcare, marketing, communications, and consumer engagement — which is something our for-profit colleagues do much better than those in public service.
  • Organizations should require their employees to go through regular public health training. Think about how often employees must pass technology safety training. Why isn’t public health in the work environment also included?

Preparing Us for the Future

While there is a reduction in COVID infections right now, the new mutations haven’t yet ravaged the country, and many are aching to get the vaccine.

This is the time to rethink what comprehensive public health education looks like and make this a priority in our post-COVID-19 world. I urge us to reimagine this future expansively, not just for graduate and medical students, but for primary school and offices too.

COVID-19 will eventually end, but — as climate change pummels forward — what can we do now to be prepared for what’s next? Let’s educate everyone about public health science as quickly as possible.

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