The History of Public Health Education

The Concept of Public Health

• Prior to the late 19th century, towns and cities made some efforts at promoting public health, usually in the form of urging proper disposal of sewage. Once scientists understood how disease was spread, concerted efforts at educating the public about how to protect themselves from viruses and bacteria began to be made. For instance, in 1893, Nathan Strauss, a New York philanthropist, established "milk stations" where nurses gave pasteurized milk to new mothers, along with instructions on properly feeding infants. Pasteurization killed the bacteria that were known to spread diseases such as typhoid fever. Industrialization, immigration and urbanization also brought up public health issues. Cities were not prepared for the onslaught of immigrants and rural citizens seeking work in factories. As a result, malnutrition, starvation, disease and poor sanitation plagued growing cities such as New York. Reformers such as Jane Addams, the founder of Hull House in Chicago, tried to improve the conditions of the urban poor through hands-on education; this era of reform is known in United States (U.S.) history as the Progressive Era.
  
  

The First School of Public Health

• During the Progressive Era, new organizations arose in conjunction with increased government funding to ameliorate the worst consequences of industrialization and urbanization in the United States. The Rockefeller Foundation was among these organizations working toward these goals, for instance, funding a commission to work toward eradicating hookworm, a disease found in areas with poor sanitation. The director of this commission was Wickliffe Rose, an educator, who became convinced that the country needed a cadre of professionals whose entire careers would be dedicated to public health. The best way to obtain this cadre would be to open a school of public health. Rose convinced the Rockefeller Foundation to fund a school of public health at Johns Hopkins during the flu epidemic in 1918. The Rockefeller Foundation funded two more schools of public health at Harvard and the University of Toronto in the following decade.
  
  

Public Health Education Prior to the 1960s

• The first public health schools emphasized research over practical training. During the Great Depression, President Franklin Roosevelt pushed a program of increased government funding and intervention in a wide range of areas, including public health. The Social Security Act (1935) offered funding to states to create their own public health services. With the funding came a requirement that states hire employees who had at least a year of public health training. As a result, training in public health became more general as states needed people with a broad understanding of public health issues. World War II increased demand for public health workers as well. Sanitary engineers and experts in disease were needed on the battlefield to prevent casualties from disease. The combination of government funding and the war led to the opening of more schools of public health during this period.
  
  

The Impact of the 1960s on Public Health Education

• A conservative government wary of social spending during the 1950s led to a brief decline in funding for public health education, but Congress passed a bill to fund training in public health during the late 1950s. In the mid-1960s, President Johnson's Great Society strove to continue the work of the New Deal in extending government involvement in social problems and included the Medicare and Medicaid legislation in 1965. These new health services led to an increased demand for public health professionals to administer them.
  
  

Public Health Education Today

• Since the 1960s, public health education has expanded into new areas, including environmental health, nursing and nutrition. According to "Who Will Keep the Public Healthy?: Educating Public Health Professionals for the 21st Century," a report from the Institute of Medicine, the U.S. currently has 32 accredited schools of public health and 45 accredited master's of public health programs.