A moving story for a school of public health

There are a lot of medical schools in the US (126 regular and 28 osteopathic schools), and you probably thought there must be a lot of schools of public health, too. It's true there are a lot more now than there used to be, but even with recent additions there are only 39 schools accredited by the Association for Schools of Public Health (ASPH), the official accrediting body (and in effect the trade association for the schools, although it wouldn't like to be referred to that way -- tough). So there are four times as many medical schools as Schools of Public Health. Says something.

The news in the world of Schools of Public Health (a world I live in, for better or worse) is that one of our number, the School of Public Health at Saint Louis University, is about to make a move to its neighbor, Washington University in St. Louis. Probably most of you reading this could care less, but for those involved, it's a big deal. I learned of this through an article in The Chronicle of Higher Education (I am not at either institution, just in case you were wondering), where this paragraph caught my attention:

Schools of public health are often considered valuable assets to universities because their faculty members can work across many disciplines and attract a range of grants from numerous fields. They are also focused on research with direct ties to their communities.

"You could certainly understand why a university would be interested in one," said Harrison C. Spencer, president and chief executive of the Association of Schools of Public Health. He said the field was expanding, with 10 new schools having become accredited since 2000. (Chronicle for Higher Ed [subscription only, alas])

Since I've spent many decades in a School of Public Health, I noted this both with faint satisfaction (why not?) and a little surprise. Even the biggest school of public health, the one at Johns Hopkins -- a school so large that other schools of public health measure their budgets in terms of fractions of the Hopkins school (now called the Bloomberg School; good thing Pampers isn't a big donor) -- plays second fiddle to the Hopkins School of Medicine. In all cases I know of the school of public health rests in the shadow of the medical school attached to the same university. That's the landscape of the health professions in the US. Cure is worth more than prevention and sure costs a hell of a lot more.

So if the St. Louis school moves to Wash U it's a win for Wash U, and probably not much of a loss for St. Louis, where the school of public health was sort of a strange fit in the first place. Wash U is a world class medical research center. Let's hope the school of public health doesn't get eaten alive.

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I'm a graduate of SLU SoPH and the school and my program were/are characterized by thoughtful, caring, and extremely capable faculty and staff. Some groundbreaking research, practice, and teaching has occured among Dr. Brownson, Kreuter, Arrington, True, Evans, and others. The SoPH has also collaborated fruitfully with elements of the SLU School of Medicine around HIV, geriatrics, ethics, etc.

Recently, however, the SoPH has been "under fire" from SLU's very "agressive" (Machiavellian?) president, Fr. Lawrence Biondi. It's my impression, after moving the SoPH to smaller and worse buildings a few times in the past 10 years, that Fr. Biondi would rather the School go away. This might be due to the contention that modern public health might be incompatible with the views of Jesuit teachings. Of course, there has always been tension between the School of Medicine and the SoPH for resources. It has seemed recently that SoPH faculty would rather work with WashU SoM faculty than SLU SoM faculty. Another piece to this is that WashU recently dropped its Health Administration program and part of the reason was that SLUs HA program was larger and "better." It might have been a strategy to do that first, then capture the SLU program, less mess. Still another wrench are the solid relationships the SLU SoPH has with the SLU School of Business and the SLU School of Law. The Health Law program has consistently ranked among the best in the nation. These relationships would likely be strained with a move to WashU - but it would be compelling to then align with among the best business and law schools in the nation. Lots of interesting aspects of this.

Point of clarification: It is the Council on Education for Public Health (CEPH) that accredits schools and graduate programs of public health. ASPH is an association representing only the schools of public health.

CEPH is an agency recognized by the US Department of Education that is supposed to be independent of the schools. Public health accreditation is it's primary function.

By interested party (not verified) on 20 Oct 2007 #permalink

Interested: Yikes. You are completely correct. This was my error, an error I shouldn't have made as I have been part of writing at least three accreditation self-studies. How independent CEPH is, however, is a slightly different question. Accreditiation was formerly required to receive federal capitation funds and CEPH was a creature of the accredited schools. The pot of money was fixed and each new school let into the club meant less for the others. Since capitation has gone away, CEPH's real significance has waned and many MPH programs are unaccredited these days, with little effect as far as I can see. CEPH still represents the views of what the accredited schools thinks accredited schools should teach. It's a dinosaur.