reconsideration of M.P.H. admission requirements to ensure that selected candidates are adequately prepared for the expanded didactic and practical training envisioned;
vastly expanded practice rotations; and
enhanced education for competence in specific careers (e.g., biostatistician or health care administrator).
The committee recommends a significant expansion of supervised practice opportunities and sites (e.g., community-based public health programs, delivery systems, and health agencies). Such field work must be organized and supervised by faculty who have appropriate practical experience.
The range of future research in public health will also be radically different from what we see today. To a far greater degree, public health research will be transdisciplinary in nature, involving applications of basic biology and social sciences, and direct participation of the community. In the current paradigm, so-called multi-disciplinary research is the predominant research mode. Transdisciplinary research involves broadly constituted teams of researchers that work across disciplines in the development of the research questions to be addressed. Research methodology typically reflects the repertoire of the principal investigator’s discipline, complemented by consultant co-investigators with additional skills. For example, at present a chronic disease epidemiologist might study the effect of an ambient air pollutant on mortality, obtaining input from an environmental chemist to help measure the independent variable (air pollutants) and a biostatistician to help explore advanced causal models.
In the future, study of the health impact of air pollutants will likely involve more broadly constituted “teams” comprised of social scientists (to measure covariation in health status caused by social factors which in the present paradigm would be viewed as “confounders”), experts in lung and cardiovascular biology (to evaluate early markers of health effect because mortality, while easily measured, is too crude an end-point given the broad and diverse population at risk), and, most novely, industrial engineers and economists to evaluate in the research context the feasibility and costs associated with alternative strategies for modifying air quality. Moreover, a far larger portion of the research portfolio is likely to be evaluative and/or intervention-focused, with interventions at the individual, community organizational, and even societal levels.
Educating individuals to conduct this research will require new approaches to the current strategy of advanced degree education at the doctorate level. The breadth of the envisioned future enterprise, and its many intersections with other scientific, biomedical and social scientific fields, suggests that an important component of science training will be