Public health schools and programs should teach all students about the existence of, reasons for, and means for eliminating racial and ethnic health disparities to increase the competence of all graduate public health students with regards to cultural and other issues that affect racial and ethnic health disparities.

Health Disparities in MPH Curriculum

While the Kellogg Taskforce was developing goals, ASPH was creating competencies for mast of public health (MPH) curricula. As a part of this process, ASPH developed competencies in five core areas and in seven cross-cutting areas. These competencies are not designed to serve as a framework for certain required core courses or for development of a core curriculum, but rather offer guidance on provision of a baseline overview of the knowledge, skills, and other attributes expected of emerging public health professionals.

One of the cross-cutting competency domains, Diversity and Culture, is defined as “the ability to interact with both diverse individuals and communities to produce or impact an intended public health outcome.” It is increasingly important that a new graduate with an MPH can perform the following:

1. Describe the roles of history, power, privilege, and structural inequality in producing health disparities



2. Explain how professional ethics and practices relate to equity and accountability in diverse community settings



3. Explain why cultural competence alone cannot address health disparities



4. Discuss the importance and characteristics of a sustainable, diverse public health workforce



5. Use the basic concepts and skills involved in culturally appropriate community engagement and empowerment with diverse communities



6. Apply the principles of community-based participatory research (CBPR) to improve health in diverse populations



7. Differentiate among availability, acceptability, and accessibility of health care across diverse populations



8. Differentiate among linguistic competence, cultural competency, and health literacy in public health practice



9. Cite examples of situations where consideration of culture-specific needs resulted in a more effective modification or adaptation of a health intervention



10. Develop public health programs and strategies that respond to the diverse cultural values and traditions of the communities being served

These objectives are a product of the MPH Core Competency Development Project.

Incorporating Health Disparities into Curricula

The ASPH Health Disparities Report addressed the following three objectives as a means of introducing racial and ethnic health disparities into public health school curricula:

• Ensure that all degree program curricula address the elimination of racial and ethnic health disparities (e.g., offer an elective course that focuses on racial and ethnic health disparities; create or maintain a minimum of one module, section, or case study that teaches students about racial and ethnic health disparities in one or more required courses).



• Develop practica placements and activities for students that include opportunities to learn about, and work toward, the elimination of racial and ethnic health disparities (in general and specifically in relation to policy issues).



• Offer in-house seminars for faculty, staff, and students to bring visibility to racial and ethnic health disparities issues.

Most if not all public health schools and programs offer courses that address the elimination of racial and ethnic health disparities. Such courses incorporate these issues through a variety of traditional and nontraditional approaches, such as highlighting differences in disease prevalence among different populations, using case studies, and having students work in settings that serve a variety of racial and ethnic populations. Some elective or required courses focus entirely on these issues (e.g., as noted in Section 1.1 of the attached Directory of Contact Information for Resources Cited).

Several schools build on this approach by offering concentrations or certificate programs that emphasize teaching students how to work toward eliminating health disparities. The Saint Louis University School of Public Health offers a concentration in Eliminating Health Disparities (EHD). Supported by the National Cancer Institute, this concentration program funds three to five students each year to receive specialized training. In addition to the two required EHD courses, students must attend a seminar series focused on research relevant to health disparities, complete a research rotation in the first year and a policy rotation in the second year, and finish an individual research project relevant to health disparities.

The most recent version of the Council on Education for Public Health (CEPH) standards and guidelines for public health schools and programs includes a requirement that students enrolled in degree programs must demonstrate the application of their learnings through a practice experience.

This requirement provides an opportunity for faculty and staff at public health schools and programs to encourage and facilitate the placement of students in practical experiences that address racial and ethnic health disparities. CEPH requires that schools and programs have well-defined learning objectives, procedures, and criteria for the evaluation of each practicum. This provides an excellent opportunity to incorporate racial and ethnic health disparities into practica that do not necessarily highlight those topics, but address such issues.

Most public health schools and programs offer regular seminars—such as deans’ lectures, grand rounds, and brown-bag presentations—that highlight cutting-edge research or address pressing public health issues. These are excellent opportunities to showcase racial and ethnic health disparities in a manner that engages students without the pressure of a classroom.

This methodology has worked well at Harvard University. The Yerby Diversity and Public Health Lectures, sponsored by the Faculty Diversity Initiative at the Harvard University School of Public Health, bring distinguished minority scientists and scholars to the school to discuss important health topics. Last March, Dr. David Satcher—Director of the Center for Excellence on Health Disparities of the Morehouse School of Medicine, Director of the Satcher Health Leadership Institute, and former Surgeon General of the United States—gave the 2008 lecture, “Public Health Leadership Opportunities for the 21st Century.”

It is increasingly more important that a new graduate with an MPH have a baseline understanding of racial and ethnic health disparities. In general, by incorporating a larger dose of diversity into all degree program curricula, practica placements, existing seminars and other student activities, it helps prepare future graduates for the real world challenge of leveling health disparities across populations.