In recent years, the way people think about health care issues has shifted: There’s an increased emphasis on prevention, rather than solely finding a cure.
This shift, said Vice-Principal (Academic) Patrick Deane, aims to keep the general population as healthy as possible and minimize potential drains on the health-care system.
With those goals in mind, Queen’s is developing a Master’s of public health degree and, eventually, a school of public health.
Planning for the program began at a town hall meeting convened by Principal Hitchcock a year and a half ago, Deane said. The meeting allowed faculty and other interested parties to offer input on the idea of a public health program at Queen’s.
“That town hall meeting led to two things: [One was] the establishment of an institute for population and public health to encourage interdisciplinary research on public health issues. [And] the University embarked on a process of developing a degree proposal for a Master’s of public health, which is the professional degree.”
The province of Ontario decided to establish two schools of public health to meet the demand for more public health education, Deane said, and Queen’s was chosen as the first university to host such a school.
Public health has become a key issue in the last few years for a number of reasons.
“I think public awareness … of the need for preventative action in human health has become very heightened at the moment,” Deane said.
For this reason, Deane is pleased to see Queen’s go ahead with the School of Public Health.
“I think we are imagining something that will be substantial, certainly if it is to be one of two in the province,” Deane said.
The first School of Public Health in Canada was created at the University of Alberta, eighteen months ago. The school offers an MPH in five different areas including environmental health, biostatistics and epidemiology, as well as a PhD in public health.
Since receiving its provisional approval in March 2006, Queen’s Institute of Population and Public Health has operated as a trans-disciplinary research network.
Kristan Aronson, director of the institute, said it’s possible there are more than two Ontario universities developing schools of public health. For many years, she said, the University of Toronto has had a school of hygiene.
“I happen to know that U of T is in the process of developing a school of public health, as are several other universities in Ontario.”
A concrete development for the School of Public Health at Queen’s began with a $200,000 grant from George Smitherman, minister of health and long-term care.
Following the grant announcement, Aronson was named as the incoming director of the new school of public health. In this role, she will be consulting both externally and internally with research and teaching groups who are interested in the school.
“What we’re trying to do is put together a plan for a major initiative for public health at Queen’s—a new building, for example, as well as endowments for new faculty and providing some new infrastructure funds for existing faculty,” she said. “It’s all at the visioning stage at this moment.
“It’s super exciting in my view at least, because it’s responding to a need both nationally and provincially and locally to increase the focus on prevention of disease and conditions in public health.”
The field of public health focuses on the health of whole populations and societies, rather than on the individual, Aronson said.
“By public health we mean to improve overall well-being of everyone in the country and everyone in the world.”
The connotation of “public” is all-inclusive. Aronson said public health focuses on marginalized and vulnerable populations, such as the extreme poor. As well as examining the problems, public health also analyzes the sources, such as crowded housing, poverty, lack of access to clean air, food, soil and water. Because of this cause-and-effect situation, public health requires an interdisciplinary approach that combines diverse educational and professional backgrounds.
“They’re recognizing that we need greater capability to deal proactively with what might be coming down the pipeway—not just in terms of the next epidemic or pandemic, but also in terms of chronic diseases, like diabetes and asthma,” Aronson said. “What we really need to develop and hope to develop in this is a much closer connection between academia and practice in public health.”
In this age of epidemics such as influenza and SARS, Aronson said the need for public health education is evident.
“Lots of levels—the United Nations, [World Health Organization] WHO, governments of Canada and Ontario, everyone—seem to have recognized the importance of public health,” Aronson said.
Within Queen’s MPH program, Aronson said, there will be two streams: global and public. For the first 12 months of the 16-month program, all students will take courses in biostatistics, health policy, behavioural sciences, environmental studies and epidemiology. Within the program, each student can also take specific courses or modules of his or her choice in areas such as chronic disease and rural health.
For the last four months of the program, each student will complete a 16-week practicum in the field of his or her interest, at an agency or an NGO anywhere in the world.
“You could call it a capstone experience—you would come back to Queen’s and share your new knowledge with others in the program,” Aronson said.
To develop the MPH, Aronson worked with a curriculum committee of 18 members from various backgrounds from Queen’s and the Kingston community. Faculty members, physicians and two students were included on the committee.
In its first year, Aronson said she aims to accept 40 students into the program.
Although establishing an undergraduate degree in public health has yet to be decided, Aronson said it’s a possibility.
The eventual outcome of the MPH program’s success would be the all-encompassing School of Public Health, which is still in the preliminary stages, Aronson said. The school, which would include programs for undergraduate and graduate levels as well as the existing research institute, is still a developing project and it could be three to five years before it opens its doors.
“It will take a large infusion of new resources for the school,” she said. “It’s all at the visioning stage at this moment—I’m looking forward to hearing from faculty and students about their ideas for a School of Public Health here.”
John Hoey, professor in community health and epidemiology, was appointed as special advisor to the Principal on population and public health development in June 2006.
Before any new graduate degree program is approved, the program proposal must be submitted to the School of Graduate Studies (SGS), then to the Principal’s budget committee and finally to the Senate. It must then be brought to the Ontario Council of Graduate Studies (OCGS) to get province-wide approval to be accredited as a graduate degree.
“[The MPH proposal has] gone through almost all the Queen’s hurdles,” Hoey said.
“We expect approval sometime in the spring and launch program in September 2008.” Although the University of Waterloo and Lakehead University both offer an MPH, the Queen’s program would offer something unique, Hoey said.
To develop an MPH curriculum distinct from other universities in Ontario, Hoey and the committee looked at other programs from across the world, including London’s School of Tropical Medicine and Hygiene. Hoey also visited Columbia University’s School of Public Health.
“They have an exceptional MPH program—it has a very strong global focus,” he said, adding that Queen’s MPH will be similar.
“It would differ in the sense of its very broad and global focus,” Hoey said. “There are courses dealing with health problems largely exterior to Canada.
“Much of public health in developing world is active conflict: how does public health work in those kinds of environments?” Hoey said.
Patricia Peppin, associate professor of law and assistant professor in family medicine, sat on the Queen’s MPH committee, as well as developed a proposal for a joint degree in law and public health, which is also going through the approval process.
“The nature of the field [of public health] brings together disciplines to solve common problems,” Peppin said.
“It’s actually interdisciplinary, not multidisciplinary, where people are just sitting beside each other and not interacting.”
Peppin said law and public health have a strong interrelation. In dealing with diseases calling for quarantine, law can help ensure the quarantined individual’s kept in humane conditions and can preserve their dignity.
“Law provides a way of framing those issues, to provide a link between health as a whole community and human rights,” Peppin said.
William Flanagan, dean of law, said the proposal for a joint LLB-MPH degree is in the process of being brought to the law faculty board.
Should the approval process go smoothly, the program will be promoted early in 2008 and will be offered to incoming students in 2009.
“I’m very delighted to be the first law school in Canada to offer a joint program in [public health] and law, and am very pleased to see it go forward,” Flanagan said, citing the popularity of such programs at schools in the U.S., such as George Washington University and Harvard University. English professor Rosemary Jolly said her research interest in HIV/AIDS and gender-based violence in South Africa got her involved in the MPH proposal.
Hoey and Aronson heard Jolly advise a joint research team from Queen’s and Tamil-Nadu in India about ethics in relation to their health research in summer of 2006 and invited to join the committee.
“I sat on the committee that devised the MPH curriculum, and I drafted the first version of its mission statement, that was subsequently developed by the committee,” Jolly said. “We worked hard to come up with an MPH that would do Queen’s justice.” A member of the general research ethics board, Jolly said that her job in the committee was to evaluate the value of MPH in how it would engage in ethics and ethical issues.
In terms of dealing with public health, Jolly said the analytical and critical thinking skills gained in a humanities background is immensely helpful in understanding the cultural background of a given environment.
“If I work with a woman dealing with HIV/AIDS [in South Africa], I am doing it with a historical knowledge of the culture,” she said. “I can never claim to know her personal history, but at least I can say that I know what she’s up against.
“It’s not something that someone in epidemiology would necessarily know.”
The all-encompassing aspect of public health is what poses a challenge for true interdisciplinary practice at Queen’s.
“Queen’s has considerable strength in various disciplines,” Jolly said. “This is the test: how do you take those strengths and make them work together? That is, make them work in an interdisciplinary setting, going into it with our hearts, not just with our mouths or feet.”
—With files from Lisa Jemison and Katherine Laidlaw
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