An Ounce of Prevention: Reducing Ageism Through the Lens of Public Health

Ageism is pervasive. The negative consequences of ageism are vast, and the literature on the effects of ageism on health and health care is extensive. The perpetrators of ageism are equally vast. While it may be tempting to believe that those who go into the fields of gerontology and geriatrics are free from these attitudes and behaviors, this is untrue. It is reasonable to suspect that future public health professionals, even those interested in gerontology, may also carry ageist ideas and practices into their professional careers. This research was developed to determine whether teaching about aging and ageism in a public health course could reduce ageism among students. Participants were students in a class on aging and public health. All students were graduate students in a Master of Public Health (MPH) program. Multiple assessments were used to assess ageism including the Framboni Scale of Ageism (FSA), a validated 29-question measure used to assess ageism, and the Succession, Identity, and Consumption (SIC) scale, another scale assessing ageism. Students were enrolled in an elective course on aging and public health, which was taught through the public health lens of disease prevention and health promotion. Health topics related to aging are discussed with an emphasis on prevention. The contributions older adults make, and the resulting improved health and well-being of self, others, and community are promoted. And the class participates in activities with a variety of community-dwelling older adults. Results show that ageism among students is reduced after the semester long course.

Strengthening Institutions for Public Health Education: Results of a SWOT Analysis From India to Inform Global Best Practices

Background: Developing public health educational programs that provide workers prepared to adequately respond to health system challenges is an historical dilemma. In India, the focus on public health education has been mounting in recent years. The COVID-19 pandemic is a harbinger of the increasing complexities surrounding public health challenges and the overdue need to progress public health education around the world. This paper aims to explore strengths and challenges of public health educational institutions in India, and elucidate unique opportunities to emerge as a global leader in reform. Methods: To capture the landscape of public health training in India, we initiated a web-based desk review of available offerings and categorized by key descriptors and program qualities. We then undertook a series of in-depth interviews with representatives from a purposively sample of institutions and performed a qualitative SWOT analysis. Results: We found that public health education exists in many formats in India. Although Master of Public Health (MPH) and similar programs are still the most common type of public health training outside of community medicine programs, other postgraduate pathways exist including PhDs, certificates and executing trainings. The strengths of public health education institutions include research capacities, financial accessibility, and innovation, yet there is a need to improve collaborations and harmonize training with career pathways. Growing attention to the sector, improved technologies and community engagement all hold exciting potential for public health education, whilst externally held misconceptions can threaten institutional efficacy and potential. Conclusions: The timely need for and attention to public health education in India present a critical juncture for meaningful reform. India may also be well-situated to contextualize and scale the types of trainings needed to address complex challenges and serve as a model for other countries and the world.

Are We Prepared for Precision Public Health? An Examination of Genomics Content in Graduate Public Health Programs

Objective With the completion of the Human Genome Project and swift development of genomic technologies, public health practitioners can use these advancements to more precisely target disease interventions to populations at risk. To integrate these innovations into better health outcomes, public health professionals need to have at least a basic understanding of genomics within various disciplines of public health. This descriptive study focused on the current level of genomics content in accredited master of public health (MPH) programs in the United States. Methods We conducted an internet search on all 171 Council on Education for Public Health (CEPH)–accredited MPH programs in the United States for genomics content in required and elective courses using the search terms “genetics,” “genomics,” and “molecular.” Results Of the 171 CEPH-accredited MPH programs examined, 52 (30.4%) schools and programs in 34 states offered some type of genomics education. Thirty-five (20.5%) schools and programs had a course in genetic epidemiology, 29 (16.9%) had a course in genetic biostatistics or bioinformatics, and 17 (9.9%) had a course in general public health genomics. The remaining 119 offered no course with a focus on genetics or genomics. In addition, some electives or specifically focused courses related to genomics were offered. Conclusion We found inadequate training in public health genomics for MPH students. To realize the promise of precision public health and to increase the understanding of genomics among the public health workforce, MPH programs need to find ways to integrate genomics education into their curricula.

Op-Ed---- Public Health as I see it- India &LMICs1

Op-Ed---- Public Health as I see it- India &LMICs1 The concepts of public health, one of the broad and vast scientific streams, is not getting required attention and support in India and other LMICs (low and middle income countries) like the western countries and HICs (high income countries) even in this covid-19 pandemic era. There are several reasons for this difference in public health encouragement between LMICs and HIC, the most significant factors are policies, lack of awareness and resources such as institutes, funds etc. Added to this the policy and decision makers seem to be ignorant about the significance of public health in reducing the burden of disease and health expenses at mass level. The field of public health will be more significant & useful if divided into Medical and Non-Medical branches as it incorporates scholars and experts of different fields and this division will increase significance, utility as well as efficiency of public health scholars. At present it is a mixture of scholars of different backgrounds and the title Master of Public Health seems quite inappropriate title for scholars’ of non-health field backgrounds called Master (of public health) with a simple 2 year course. Moreover the non-medical graduates will find difficulty in getting primary data related to health sciences and vice versa is also true for medical graduates and scholars. For example the non medical scholars doing research on Kala-azar don’t have enough knowledge of kala-azar to interpret the findings like spleen size, life cycle of vector, modes of transmission etc. and vice versa is also true for medical graduates. Since the preparedness and efficiency of these scholars depends on the education they receive and how effectively they use it, the training and work field should be designed as isolated fields to make the scholars’ real master instead of making jack of all trades Master of nothing. This is one of the reasons why the scholars of public health are not getting good jobs, enough attention and reputation. Added to this the credibility and reliability of public health experts can be endangered by practice of using secondary data in research largely derived from medical graduates. Hence it’s better if the public health experts department with proper division is established to reap the maximum benefits from scholars of different fields. Public health consists of experts from different fields and services which can be utilized in cases of emergency and critical support. Their abilities can be utilized while managing existing cases of non-communicable diseases like diabetes, hypertension, heart ailments, routine ante-natal care, accidents, as well as communicable disease like covid-19 if we have a clear role to be played by public health scholars. For example let the management public health expert do the management works while let medical public health experts find out the formula to deal with covid-19 as medical public health experts. Of course everyone will have importance and at the same time expertise in their respective field which can be utilized as team work to deal with various healths related issues. The significance of doctors, nurses, technicians and other hospital-based staff have been noticed and praised during this covid-19 era but still the public health experts are not getting enough attention, why? Taking example of covid-19, Public health experts may not be able to provide sophisticated complex treatments but their role in preventing, identification of cases, contact tracing, quarantine and isolation monitoring, referrals, logistic management etc. would prove helpful and significant to deal with the situation. Their ability would depend on their training about the infection and its identification, transmission, diagnostics and treatment support. India has a three-tier public health system for provision of primary (HSC, APHC, and PHC), secondary (provided by SDH, CHC, and DH specialist on referral from primary care provider) and tertiary (medical college hospitals etc. highly specialized medical care) care. All these centers must have public health experts well qualified and trained to reduce the burden of disease as well as OOPE (out of pocket expenditure) at mass level. India and other LMICs must focus now on preparing the qualified, skilled public health soldiers in order to reduce the burden of disease and health care expenses which are interfering with the nation's development.1. DR PIYUSH KUMAR, M.B.B.S., EMOC (FOGSI), PGDPHM,SENIOR MEDICAL OFFICER, HEALTH DEPARTMENT, [email protected] Mobile-+919955301119/7677833752,GOVERNMENT OF BIHAR

Ethics and Epidemiology

This book will be of interest to public health professionals from various public health disciplines, bioethicists, legal scholars, and members of nonprofit organizations, government agencies, and health advocacy organizations. It will be an invaluable resource for the thousands of Master of Public Health students across the world. It also aims to make students, epidemiologists, and health professionals aware of situations that require moral reflection, judgment, or decision, while pointing to ways in which justified moral conclusions can be reached. The book will also be of use to persons interested more broadly in bioethics and health policy. It will include the foundations, key values and principles, methods, and issues related to ethics and epidemiology.

The Missing Professional Perspective: Medical, Veterinary, and Dual Degree Public Health Student Perceptions of One Health

Introduction: One Health (OH) is an important concept to design appropriate public health responses to emerging diseases such as COVID-19. How trainee health professionals understand this concept is important to its implementation. In this study, we explored how medical (MD), veterinary (DVM), and dual degree MD and DVM Master of Public Health (MPH) students define OH and its relevance to practice.Methods: Students participated in a survey that included the Readiness for Interprofessional Learning Scale (RIPLS), and two questions requiring them to define and explain the relevance of OH. The transcripts of the OH responses underwent thematic analysis. Role theory was used to explain the variation in how students from these different programmes viewed the concept.Results: The responses of the MD and DVM students in contrast to the dual degree MPH students reflected gaps in their understanding of the concept that pertained to the specific health impacts of global warming; antimicrobial resistance, food security; social, cultural and environmental determinants of zoonoses occurrence, and health policy formation.Discussion: Mitigation of the global risks to public health require a collaborative approach by health professionals. Our findings suggest that MD and DVM students are unaware of many factors that impact patient health outside of their own discipline. The inclusion of dual degree students revealed novel insights that undertaking an MPH may have enabled them to be more aware about the interdisciplinary relevance of OH to their professional practice. We recommend that structured incorporation of OH should inform future medical and veterinary curricula.

The Design of a Master of Public Health Professional Development Course During the COVID-19 Pandemic: Application of the Salmon Model

Coronavirus disease 2019 (COVID-19) has highlighted the need for well-trained public health workers to interpret evidence, make informed decisions, and disseminate information to the general public. As public health courses in Ontario universities have moved online due to this pandemic, instructors were required to simulate their teaching online while maintaining student engagement. Previous research has shown that there is a lack of description for the development of online public health courses. As such, the objective of this article is to outline the development and layout of a Professional Development Studio course offered in the Masters of Public Health program at McMaster University, Hamilton, Ontario. We use the Salmon model, previously described by Salmon and colleagues in 2013, to form the course outline. The Salmon model provides a five-stage framework for the development of a concise, engaging, and impactful online course. Based on student feedback, we found that the Salmon model positively shaped the development of the course by aiding the formulation of a course layout that was easily accessible, discussion threads to communicate in an inclusive and safe space, and relevant assessments requiring the use of tools to make judgments and appropriately disseminate information publicly. We conclude that the Salmon model is a helpful framework to use in developing an engaging online public health course. Further assessments based on student feedback should be completed to continually evolve the online course to better tailor the needs and interests of public health students preparing them for the public health workforce.

A Report on a Visit to the School of Tropical Medicine and Global Health, Nagasaki University

Introduction: In August 2018, three Master of Public Health (MPH) students from the Faculty of Medicine and Health Sciences, University Malaysia Sabah visited the School of Tropical Medicine and Global Health (TMGH), Nagasaki University in Japan. Methods: They were joined by a faculty lecturer from the Community and Family Medicine Department. The objective of the ten-day educational trip was to attend the short course on Spatial Eco-Epidemiology Technologies at Public Health at Nagasaki University, School of TMGH. Results: The trip provided students with practical and theoretical experience of the latest technologies in the field of spatial eco-epidemiology. It also provided an opportunity to learn from the Japanese culture and gave them a well-rounded foundation upon which to build their knowledge for future careers in public health. Conclusion: This fantastic opportunity would not have been possible without the generous support and funding provided by UMS Student Mobility Programme.

Postgraduate Employment Outcomes of Undergraduate and Graduate Public Health Students

Objectives A key goal of schools and programs of public health is to prepare graduates for careers in the public health workforce after graduation, but are they achieving this goal? We assessed how the employment outcomes of students earning public health degrees are collected and described in the literature. Methods Using the Kirkpatrick model of training evaluation as a framework, we conducted a 6-step scoping review: (1) formulating the research question, (2) identifying relevant studies, (3) selecting studies, (4) charting the data, (5) collating and summarizing the results, and (6) consulting stakeholders. We included articles published from January 1, 1993, through July 4, 2020, that provided data on employment status, employment sector/industry, job function, or salary of public health graduates. We excluded articles that were not written in English and were about dual-degree (ie, doctor of medicine–master of public health) students. We found and reviewed 630 articles. Results We found 33 relevant articles. Most articles focused on a single school and combined multiple graduating classes, focused on subspecializations of public health, or focused on graduates’ satisfaction with their curriculum but not employment outcomes. Data were inconsistently categorized, and studies were difficult to compare. Conclusions Research on public health graduates’ employment outcomes is scarce and does not follow consistent protocols. New standards should be adopted to systematize the collection of data on employment outcomes of public health graduates.