The Program in Public Health was established at Stony Brook to train people who wish to integrate the knowledge, skills, vision, and values of public health into their careers and provide leadership in the field. The Program leads to the Master of Public Health (MPH) degree as well as a variety of combined and concurrent programs.
The Program advocates a population health approach to public health. The hallmarks of population health include ecological understanding of the determinants of health and a systems approach to solving health problems; emphasis on proactively stabilizing and improving health among all populations; and insistence on accountability, evidence-based practice, and continuous performance improvement. The population health approach requires multi-disciplinary collaboration among scholars in the social, behavioral, clinical, and basic sciences and humanities. Furthermore, it incorporates the development of comprehensive health information systems, and the use of advanced analytical tools to examine health problems and evaluate responses.
The population health orientation is consistent with the traditions of public health and with recent Institute of Medicine (IOM) recommendations for public health education, although it expands upon them. The IOM recommends that public health:
"Adopt a population health approach that builds on evidence of multiple determinants of health. ... (Develop) appropriate systems of accountability at all levels to ensure that population health goals are met; ... Assure that action is based on evidence;"
The population health orientation of the Program is also compatible with the educational philosophy of the Medical Center (originally part of the Health Sciences Center). The Health Sciences Center, opened in 1971, emphasizes the need for interdisciplinary education and collaboration, and recognizes the need for health professions to work together. The Graduate Program in Public Health values the importance of a collegial atmosphere at an early stage in an MPH student’s education in order for the student to gain respect for the diverse backgrounds and competencies of fellow students.
The emphasis of the Program in Public Health reflects the changing environment in which public health practice occurs, and recent thinking about how to respond to these changes. Public health retains its distinct role as the specialty emphasizing prevention, with the object of its work being populations, in contrast to the historical role of medicine, dentistry, and other clinical disciplines that focus on healing, with the object of their work being individuals. "The public health professional is a person educated in public health or a related discipline who is employed to improve health through a population focus."
Since the 1980s, the three main functions of public health have been identified as assessment, policy development, and assurance. However, the knowledge and skills needed to perform these functions optimally has changed radically in light of advances in information technology and increased knowledge about the determinants of health and disease. These changes are occurring at all levels of inquiry - from the micro (genetics and microbiology) through the macro (the social sciences). Changing political, economic, demographic, and social conditions in the United States and the world make the application of new knowledge and technologies all the more important.
As one recent Institute of Medicine report states, "The beginning of the twenty first century provided an early preview of the health challenges the United States will confront in the coming decades. The system and entities that protect and promote the public health, already challenged by problems like obesity, toxic environments, a large uninsured population and health disparities, must also face emerging threats, such as antimicrobial resistance and bio-terrorism. The social, cultural, and global context of the nation's health is also undergoing rapid and dramatic change. Scientific and technical advances, such as genomics and informatics, extend the limit of knowledge and human potential more rapidly than their implications can be absorbed and acted upon. At the same time, people, products, and germs migrate, and the Nation's demographics shift in ways that challenge public and private resources."
Recent, influential reports regarding public health education suggest ways to address the evolving training needs of public health professionals. These publications include one report issued by the Centers for Disease Control and Prevention - Public Health's Infrastructure - and three reports from the Institute of Medicine - Who Will Keep the Public Healthy?; The Future of Public Health in the 21st Century; and Crossing the Quality Chasm. The recommendations in these reports challenge new public health programs to train public health leaders to be boundary spanners - able to use the new tools and knowledge available in order to formulate solutions to the complex public health problems facing us. "Public health professionals have a major role to play in addressing these complex health challenges, but in order to do so effectively, they must have a framework for action and an understanding of the ways in which they do affect the health of individuals and populations."
These recent recommendations regarding public health can be synthesized as follows. In addition to the traditional knowledge, including epidemiology and biostatistics, public health leaders need:
- An ecological understanding of the causes of poor health including, social, behavioral, environmental, occupational, demographic, policy, economic, and genetic factors as well as the interrelationship of these factors;
- A thorough understanding and appreciation of the cultural heterogeneity of populations, its impact on public health initiatives, and tools to deal with issues arising from cultural heterogeneity;
- A thorough understanding of the current system of addressing poor health - medical, dental, and public health - including organization, financing, regulation, accessibility, quality, effectiveness, and efficiency;
- An orientation toward policy, as well as programmatic, solutions to public health problems and the skills to assess, develop, implement, and evaluate policies;
- An orientation favoring evidence-based decision-making and the skills to develop evidence for public health decision-making including study design and analysis of data;
- An orientation favoring accountability and continuous quality improvement in public health and the skills needed to measure accountability and assess performance;
- Informatics skills including application of information technology to obtain, organize, and maintain useful data for public health decision-making;
- Leadership skills including the conceptual and analytical tools to prioritize problems and make sound decisions.
Instilling a population health orientation and fostering the skills necessary to act upon it provide the Program’s graduates with the ability to meet the basic needs of public health today – defined as provision of the Essential Public Health Services and the three core public health functions (assessment and monitoring; formulating public policies; and assuring access to appropriate and cost-effective care) - as well as to expand the work of public health to achieve its broad mission "to fulfill society's interest in assuring conditions in which people can be healthy."