Lutheran Public Health Programs: A 21st Century Need

Aug 11th, 2017 | Category: Lutheran Education Commentary, Research in Education
By Christian B. Albano, Melinda Mastel, Michael Cottonaro II, Arthur Antunes de Souza Pinho, Dean L. Arneson, and Robert Burlage

Editor’s note: This article marks an expansion of the mission of Lutheran Education Journal. At its inception in 1864, LEJ focused solely on Lutheran elementary schools. One-room schools taught in the main by the pastor who was studying at the Lutheran Evangelical Teachers Seminary. As schools and congregations grew, the focus moved to the person solely in the ministry of teaching. As Lutheran schools continued to grow, the focus of the journal also grew to include Lutheran secondary education and then Lutheran early childhood education as well. Now we are at another milestone, writing and reading about Lutheran higher education. While Lutheran higher education for the schooling of children began in 1864, this is the first time the journal has published an article addressing needs in Lutheran higher education. The expansion of our Concordias into liberal-arts universities brings with it the need to consider courses and programs that our first editor, Dr. Lindemann, never could have imagined.

What is public health?

Public health origins can be traced back to the Biblical book of Leviticus, believed to be the first written public health code in the world (Stahl, 2003). Since 1500 BC, the field has grown, expanded, and developed into one of the most prominent emerging educational opportunities today. Defined by the World Health Organization as “organized measures to prevent disease, promote health, and prolong life among the population as a whole,” public health extends beyond treatment of individuals to employ proactive outreach, education, and empowerment to entire communities (American Public Health Association, 2014; World Health Organization, 2016).

Public health is omnipotent; observed and interacted with throughout daily life. Initiatives involving public health include health education, environmental health, clinical practice, health policy and management, occupational health, health equality, bioethics, infectious disease prevention and control, social and behavioral health, community engagement, global health, and geographic information systems (Boulton et al., 2014). More specific examples of how each of these topics relates to public health can be viewed in Figure 1: A map of public health disciplines (Mastel, 2016b).

Why is public health important?

Figure 1 : A map of public health disciplines.

Public health is integral to society and the world, and its necessity has led to some deeming it “more important than health care” (Gordon, 1993). According to the American Public Health Association, public health developments will continue to make positive impacts into the future. This association states that In the past, public health developments have improved quality of life, playing a role in increased life expectancy since 1900, while in the future, public health research, initiatives, and interventions hold promising potential for preventing and treating today’s most pressing health conditions especially chronic and preventable diseases such as diabetes, obesity, cancer from tobacco, etc. (2014). (2014, n.p.)

Health care fulfills a critical role in diagnosing and treating injury and illness, however public health focuses on proactive measures to prevent injury and reduce the spread of disease (American Public Health Association, 2014). Effective public health initiatives can reduce morbidity and mortality, decrease health expenditures, and inform and empower individuals, communities and populations to make healthy choices.

How do students become trained in public health?

The most common public health degree is the Master of Public Health (MPH). Other educational avenues to obtaining training in public health include a bachelor’s degree in public health, doctorate in public health (DPH or PhD), and certificate programs (Council on Education for Public Health, 2015). Dual degrees have emerged which combine public health education at a graduate level with other fields of study, including nursing, social work, pharmacy, medicine, and law (MPH/MSN, MPH/MSW, MPH/PharmD, MPH/MD, MPH/JD, etc.). Some schools offer generalist public health degrees, while others offer the opportunity to specialize in a public health discipline such as health education, global health, or health policy (Association of Schools and Programs of Public Health, 2016). The common areas of study in schools and programs of public health can be found in the literature of the Association of Schools and Programs of Public Health (ASPPH).

TheASPPHprovidescurricular guidance and standardized learning outcomes for graduates of public health programs. The Council on Education for Public Health (CEPH) is the primary accrediting body for public health programs. Currently, 2,470 programs across 109 schools are accredited by CEPH (Council on Education for Public Health, 2015). There are 59 schools of public health accredited by CEPH.

What needs exist in Lutheran public health graduate education?

As healthcare reform arrives at the forefront of current discussion in the healthcare industry, prevention focused public health is projected to grow in demand and importance. The relative nonexistence of Public Health education in Lutheran higher education is alarming. An assessment (via internet search databases, public health course and program information was obtained and recorded via spreadsheet) of current Lutheran public health programs found that there is an opportunity for creation, growth, and innovation of public health programs, particularly Master of Public Health (MPH) programs, in Lutheran colleges and universities (Mastel, 2016a). Out of the 42 Lutheran institutions of higher education researched, four were found to have existing public health programs, with two of these programs being MPH programs at the graduate level (Mastel, 2016a). Click on this link to see the comprehensive list of existing courses and programs in public health at Lutheran Colleges and Universities (Mastel, 2016a). Additional key findings of the Forty-two Lutheran Institutions that were researched:

  • Two out of three offer public health-related courses
  • Four have existing public health programs (~10%)
  • Two of these programs are Master of Public Health (MPH) programs at the graduate level

Figure 2: Overview of existing Lutheran public health programs

Furthermore, none of these programs are accredited by the Council on Education for Public Health (CEPH). An opportunity exists, then, not only to develop public health programs within Lutheran colleges and universities, but also to seek accreditation of such programs by CEPH. Public health-specific accreditation of Lutheran public health programs may help certify a well- balanced curriculum and also demonstrate the fulfillment of standards met by other well-regarded public health schools across the country.

While approximately only 10% of Lutheran colleges and universities currently offer a public health major or degree, two out of three do offer public health-related courses. Twenty-one percent of these courses are at the graduate level, often as part of Master of Business Administration (MBA), Master of Health Administration (MHA), or Master of Public Health (MPH) programs. For those schools which have not yet developed or implemented a public health program, these courses provide a valuable resource upon which to base a public health program and may even reduce the financial and time commitment involved in developing a public health program. Figure 2 provides an overview of existing Lutheran public health program and demonstrates the summary of our assessment (Mastel, 2016c).

Why a Lutheran public health program?

There are many appealing reasons for formation of a Lutheran public health program. Public health builds upon the emphases of servant leadership, community outreach, and stewardship set forth in the mission, vision, and values of existing Lutheran education institutions. Public health as a field thoroughly embodies the concept of “servant leadership,” with roles focusing on helping others rather than elevating personal status or seeking visibility or recognition. Servant leadership is often emphasized throughout the Lutheran faith, and by Lutheran colleges and universities such as CUW (Lutheran Church Missouri Synod, 2016). While the decision to act as a servant leader can be applied to any field, public health provides plentiful opportunities for individuals seeking highly meaningful and impactful careers (Public Health Online, 2016). Public health is also a prime field for contributing to those in underserved areas, including urban and rural populations.

Developing a framework for a Lutheran public health program

Concordia University Nebraska provides an example of an existing online MPH program with specializations in both community health education and health policy and administration (Concordia University Nebraska, 2016). While not accredited by CEPH, the program is evidence of a successful implementation of preparing students to fulfill a vocation in public health and can serve as a framework for future development of Lutheran public health programs.

Several courses already offered by Lutheran colleges and universities could provide the foundation for development of public health programs at the undergraduate and graduate levels. These courses include (Mastel, 2016a):

  • Bioethics
  • Bioinformatics
  • Biostatistics
  • Economics & Public Policy of Healthcare
  • Epidemiology
  • Global Health
  • Health Advocacy
  • Health Communication
  • Health Diversity & Global Issues
  • Health Program Planning & Organization
  • Healthcare Informatics
  • Healthcare Law
  • History of Public Health
  • Human Health and Disease
  • Infectious Disease
  • Introduction to Public Health
  • Nutrition
  • Personal & Community Health
  • Population Biology
  • Prevention in Public Health
  • Public Health Education and Promotion
  • US Healthcare Delivery
  • Workplace Health & Safety

The Bioethics graduate certificate at Concordia University Wisconsin, part of the Concordia Center for Bioethics, also provides a foundation for bioethics programming, an emphasis in the core competencies of public health as well as a concentration of many public health programs (Concordia University Wisconsin, 2016b). CUW’s Bioethics graduate certificate trains students to compare approaches to bioethics, consider bioethical issues and theological and philosophical questions, analyze bioethical challenges, evaluate the applicability of law to bioethics, and devise organizational and governmental policies that serve to protect and promote public health (Concordia University Wisconsin, 2016c). This program provides five courses which relate to public health, each of which could be incorporated into a potential public health program (Concordia University Wisconsin, 2015):

  • Moral Reasoning and Bioethics
  • Clinical Issues in Bioethics
  • Bioethics and Biotechnology
  • Bioethics and the Law
  • Policy Issues in Bioethics

The creation of the Bioethics certificate also demonstrates the recognition of bioethics, an interdisciplinary field like public health, as a worthwhile investment and educational program topic for the upcoming generation of healthcare leaders—further support for more extensive creation of Lutheran public health programs.

Opportunities for collaboration and growth

Additional opportunities for a Lutheran public health program include partnerships between Lutheran institutions of higher education and the creation of additional programs beyond the MPH, such as a dual bachelor’s degree and MPH program as well as certificate and doctoral programs.

Through the cooperation of multiple colleges and universities, a Lutheran public health program could utilize the strengths of several institutions to provide an innovative approach to public health education. Whether through a collaboratively authored curriculum, sourcing public health field experience opportunities across a vast geographic span, or widening the scope of offered specializations through shared professorial talent, an interconnected Lutheran public-health program could provide valuable opportunities for students and schools alike.

A dual bachelor’s degree and MPH program is another opportunity for expansion upon a foundational public health program. A dual bachelor’s degree and MPH program could offer students the opportunity to combine graduate study in public health with another field of interest; this dual degree program has similar logistics to the Business Scholar Program, a 4-year BS and MBA dual degree at Concordia University Wisconsin (Concordia University Wisconsin, 2016a). With the breadth of public health career opportunities available (Boulton et al., 2014; Public Health Online, 2016), students from many undergraduate majors could benefit from such a program, including those studying nursing, business, social work, biomedical sciences, mathematics, a global language, or education.

How could Lutheran colleges and universities better prepare students for a vocation in Public Health?

A Lutheran public health program enhances students’ ability to obtain and contribute to a career in one of the many disciplines relating to public health. A Lutheran program also provides the unique opportunity to develop a perspective of servant leadership and understand the purpose of fulfilling a vocation, thereby preparing students not only to be knowledgeable, skilled professionals but also to serve Christ through their career.

Public health is a wide-ranging field encompassing many career paths and opportunities (Public Health Online, 2016). This allows for students from many undergraduate or graduate degree areas and a variety of career backgrounds to meaningfully prepare for a future career in public health. Public health career opportunities are below and each of these careers offers the opportunity to apply knowledge and passion to a vocation in service of others. (Boulton et al., 2014):

  • Public Health Officer/ Director
  • Program Manager/ Coordinator
  • Epidemiologist
  • Health Educator
  • Public Health Informatics Specialist
  • Statistician
  • Lab technician/Medical technologist
  • Public Health Nurse
  • Public Health Nutritionist
  • Public Health Dentist
  • Public Health Physician
  • Public Health Social Worker
  • Grants Specialist

Benefits to Lutheran colleges & universities.

Needs for future public health professionals are expected to increase, with a projected need for 250,000 additional public health professionals by 2020 and several public-health occupations projected to experience faster than average job growth (Johnson, 2008; Rosenstock et al., 2008). Lutheran colleges and universities have the opportunity to prepare students to meet these needs while equipping them with a strong Lutheran perspective through the development of a Lutheran public health program. In addition, initial surveying of students at Concordia University Wisconsin’s School of Pharmacy indicates student interest in completing an MPH degree, with 25% of respondents indicating interest in earning an MPH and 90% of respondents believing a dual degree would be beneficial to a future career (Cottonaro, M. 2016).

Collaboration and partnerships to create an interconnected program or program network, as described above, also provide Lutheran colleges and universities the valuable opportunity to strengthen awareness of Lutheran education at all levels from early childhood through secondary, participate in meaningful innovations in education, and leverage strengths to offer a cutting- edge program. A strategic analysis (SWOT Analysis) yields:

Strengths/Opportunities

  • Integrates and synergizes Lutheran values with public health
  • Enhances a school’s programmatic offerings
  • Provides students with flexibility for career opportunities
  • Provides further study for an emerging and critical vocation
  • Contributes to healthier communities and people
  • Expected favorable return on investment
  • Existing courses provide a framework for future programs
  • Potential for development of a connected program within Lutheran Higher Education Institutions
  • Opportunities to include online or global components, multiple concentrations, or dual bachelors and MPH program

Weaknesses/Threats

  • Logistics and resources needed for starting a program
  • Lack of reputation as a newcomer to the degree
  • Implementation involves many steps
  • Important to carefully monitor the potential market for a public
  • Health program to avoid over-saturation of degrees and excessive competition

Call for a Lutheran public health program

Research has demonstrated both a need for development of Lutheran programs in public health and a strong appeal for creation of Lutheran programs in public health based on the field’s importance to society, positive career outlook, and connection to the Lutheran mission. Further discussion about creation of Lutheran public health programs (LPHP), especially one which includes partnership across multiple Lutheran institutions of higher education, is strongly encouraged. We recommend and conclude that a collaborative CEPH accredited LPHP effort on behalf of a network of Lutheran postsecondary institutions would have the potential to establish a meaningful presence in public health and reach communities across the nation through engaging Lutheran schools in preparation for an emerging profession. LEJ

References

American Public Health Association. (2014). The role of public health in ensuring healthy communities. Retrieved from http://www.apha.org/policies-and-advocacy/public-health-policy-statements/policy-database/2014/07/30/10/48/the-role-of-public-health-in-ensuring-healthy-communities

Association of Schools and Programs of Public Health. (2016). Common Areas of Study. Retrieved from http://www.aspph.org/study/#areas-of-study Boulton, M. L., Beck, A. J., Coronado, F., Merrill, J. A., Friedman, C. P.,

Stamas, G. D., Tyus, N., Sellers, K., Moore, J., Tison, H.H., Leep, C. J. (2014). Public health workforce taxonomy. Am J Prev Med, 47(5 Suppl 3), S314-323. doi:10.1016/j.amepre.2014.07.015

Concordia University Nebraska. (2016). Master of Public Health Degree Online. Retrieved from http://onlineprograms.cune.edu/mph/masters-degree-in-public-health-overview

Concordia University Wisconsin. (2015). 2015-2016 graduate and professional studies catalog. Retrieved from https://www.cuw.edu/academics/_assets/catalogs/catalog_grad_20152016.pdf

Concordia University Wisconsin. (2016a). Business Scholars Program (BS and MBA Dual Degree Program). Retrieved from https://www.cuw.edu/academics/schools/sba/scholars/business.html

Concordia University Wisconsin. (2016b). Concordia Center for Bioethics. Retrieved from https://www.cuw.edu/organizations/bioethics/index.html

Concordia University Wisconsin. (2016c). Graduate certificate in bioethics.

Retrieved from https://www.cuw.edu/programs/bioethics/index.html Cottonaro M, A. C., Arneson D, Burlage R, de Souza Pinho A. (2016).

Comparison of Pharm.D. “dual degrees” and pharmacy residencies utilizing a directed questionnaire for current CUW pharmacy and pre-pharmacy students. Paper presented at the MBAA (Midwest Business Administration Association), Chicago, IL.

Council on Education for Public Health. (2015). Search for a Degree Program.

Retrieved from http://ceph.org/accredited/search/

Gordon, L. (1993). Public health is more important than health care. J Public Health Policy, 14(3), 261-264.

Johnson, T. (2008). Shortage of U.S. public health workers projected to worsen: About 250,000 new workers needed. Medscape.

Lutheran Church Missouri Synod. (2016). Servant Leadership. Retrieved from http://servantevents.lcms.org/SEResources.asp

Mastel, M. (2016a). Lutheran Colleges Listing, Existing courses and programs in public health at Lutheran Colleges and Universities (pp. Existing courses and programs in public health at Lutheran Colleges and Universities).

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Author Information

Christian Albano is currently an Associate Professor of Pharmacy Administration at Concordia University Wisconsin School of Pharmacy. He has teaching and research experiences in pharmacy education, healthcare systems, management, health economics, research de- sign/methods, public/population health, pharmacology and pathophysiology. He has become an advocate for public health education. He has been instrumental with the development of public health programs and curricula. He received his B.S. in Kinesiology from University of Illinois at Chicago; M.S .in Education, PhD in Pharmaceutical Science, and MBA from North Dakota State University. He also obtained an MPH from the University of Minnesota.

Melinda Mastel is currently a Financial Associate at the Medical College of Wisconsin. She received a dual degree (B.S. M.B.A.) in Business Administration at Concordia University Wisconsin under the Business Scholars Program in 2016.

Michael Cottonaro II is currently a pharmacist at Walmart and a guest lecturer at Concordia University Wisconsin. He received his Doctor of Pharmacy degree (PharmD) at Concordia University Wisconsin in 2017.

Arthur Antunes de Souza Pinho is currently a pharmacy student at Federal University of Valedo São Francisco, Petrolina, PE, Brazil. A burgeoning public and global health advocate and researcher, Arthur was a summer exchange student at Concordia University Wisconsin from 2015–2016.

Dean L. Arneson received his Doctor of Pharmacy degree, Master of Science and Doctor of Philosophy degrees from the University of Nebraska Medical Center. He has been a licensed pharmacist for more than 35 years and has practiced in numerous settings: community, hospital, industry and as a consultant. Dr. Arneson has held academic/administrative positions at several universities before becoming the founding Dean for Concordia University Wisconsin School of Pharmacy.

Robert Burlage received his Doctor of Philosophy degree in Microbiology from the University of Tennessee. Dr. Burlage has held academic and faculty positions at several universities before becoming the Chair of the Department and Pharmaceutical and Administrative Sciences for Concordia University Wisconsin School of Pharmacy. He was also instrumental in the development of the School of Public Health at the University of Wisconsin–Milwaukee.