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Back to the pump handle: public health and the future of undergraduate education.

Article Excerpt
IN FEBRUARY 2007, CNN viewers watched as thousands of turkeys were herded to slaughter in England. The flocks were destroyed to stop an outbreak of avian flu. The same day brought news of disastrous flooding in Indonesia, where nearly three-quarters of Jakarta was under water. A week or two later, devastating tornados hit Florida and then ripped through the Mississippi Delta. New York City announced plans for a system to detect dirty bombs and bioterror devices. The popular blog Daily Kos posted a story on the threat of pandemics to the Internet, a posting that had nothing to do with software viruses: if disease closes schools and businesses for extended periods, students will have to learn and employees will have to work at home--and the Internet may collapse. A recent listserv posting to the American Council of Academic Deans asked, in the naturalizing tone of such inquiries, about campus plans for pandemics. This is our new reality. And with each successive report of the United Nations' Intergovernmental Panel on Climate Change (IPCC), terrible prospects loom larger and make stronger claims on our attention.

There is a common feature to these reports: each presents a threat to public health; most present a threat on a global scale. Informed citizens are unlikely to miss the sober news or ignore the need for action. Global Internet communications enhance the immediacy of crisis by spreading information so quickly that it is difficult to separate imminence from potential and to discriminate between appearance and reality. How to handle the flow of information--let alone the emotional demands--find practical responses, and begin systemic intervention will be the great challenge of our times. In this century, there is no reason to think we will face fewer disasters, dislocations, crises, emergencies, and chronic threats to the environment--to global human health, social well-being, and human sustainability--than we have faced over the past few years. The IPCC tells us we are going to face more.

Toward an educated citizenry

Given the magnitude of the challenges to public health confronting the world in the twenty-first century, many of us are wondering anew how to prepare our students for citizenship. If there is power in learning, it finds expression in practice and enables the practitioner to live well. Confident in the pillars of liberal education, we believe that learning shapes and guides our lives. We stand for the transformative power of education, and we trust that we are producing effects on society through our teaching, no matter how hard it may be to document outcomes or to know how and when our courses have been instrumental. But with such grim facts before us, what, we ask, do we teach? What and how do we teach when the need for an educated citizenry appears never to have been greater? How do we teach sustainably, enabling people to think ethically, systemically, and systematically about the health of humanity? How to think beyond the crises of the moment or the alarmism and panic that prompt short-term and misguided responses?

We believe that colleges and universities ought to heed the National Academy of Sciences' Institute of Medicine's (IOM) call for an educated citizenry. In 2003, IOM recommended that all undergraduates be given "access to education in public health" (Gebbie, Rosenstock, and Hernandez 2003, 144). An educated citizenry, they reasoned, is essential to a healthy society. We need citizens who possess an ability to think about the big picture, beyond the individual or constituency. We need citizens who can help as individuals to change social behavior and who are aware of the need for systemic health care, good nutrition, decent housing, and sustainable urban centers. We need...

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