Undergraduate public health education is becoming a national trend. Will Tufts keep up?

NOTE: This article is a slightly longer version of the one that appeared in the April 22, 2014 print issue.

“Where are the professors going?” asked a Facebook event title that spread around the Tufts community two weeks ago. “No, but really, what’s going on?”

The event page was created by two seniors majoring in Community Health, Katie Li and Sarah Diaz, to rally their peers to attend a “state of the major” town hall event designed to respond to student concerns about the program. Those concerns were sparked by the recent departure of Professor Linda Martinez, the third lecturer in Community Health to leave Tufts in two years after Professors Edith Balbach and Kevin Irwin retired.

Li and Diaz told the Observer that they organized students to attend the forum because they were concerned that Community Health was not a primary major and that professors lacked tenure opportunities. They also collected 83 responses in a survey of Community Health majors, which reflected the student community’s desire for increased resources for the program.

Professor Jennifer Allen, director of the Community Health program, said she organized the forum to hear student concerns and solicit opinions on how to improve the program. She stressed that while three professors leaving in two years seems rapid to students, “with a small faculty this level of turnover is not at all above average.”

Community Health has strong roots at Tufts, with the undergraduate program beginning in 1975 as a certificate program, when undergraduate education in public health and interdisciplinary fields in general was much less common. “The idea that we can train people at an undergrad level in a liberal arts setting was very exciting,” Allen said, referring to the program’s early days. The program began to offer Community Health as a second major only in 2002. The major attracted 38 students in its first year, and has steadily grown, consistently drawing between 50 and 80 students a year.

The world of public health education has changed greatly since 1975. In a 2003 article called “Who Will Keep the Public Healthy?” the Institute of Medicine of the National Academies recommended “all undergraduates should have access to education in public health.” And, given the aging population of public health practitioners and the introduction of the Affordable Care Act, “there is a growing need for people who can work in this field,” Allen said.

More and more of Tufts’ peer schools, like Cornell, Duke, and Georgetown (among many others) are offering public health majors.

Against the backdrop of rapidly growing undergraduate offerings in public health, students at the forum voiced frustrations that Community Health remains a second major. According to Li and Diaz, many students know they want to pursue the major, but end up declaring it late because they must first declare another major. In their survey of 83 students in the program, 67% of respondents said they wished Community Health were a primary major.

Allen is optimistic about the program’s prospects of becoming a primary major. “At this point in time, it’s a very well-accepted major. There are now many, many schools that are now offering this as a primary major, even within our liberal arts peer schools…. I think that students are ready and I think that our curriculum is in good shape.… My guess would be that there’s fairly widespread consensus that this could be a legitimate primary major.” Professor James Glaser, the Dean of Academic Affairs for Arts & Sciences, also told the Observer that Community Health’s status as a second major is being re-examined.

Students also voiced concern about the variety of classes being offered after the recent faculty turnover. “More than Community Health being a primary major I’m concerned with the curriculum requirements and faculty hiring,” said senior Rae Axner. “Considering that huge racial disparities exist in health measures across the board in the US, the core requirements of the major should force students to confront this reality and recognize it as one of the most pressing public health issues.”

In addition to issues of racial disparities, Li and Diaz identified community mental health and health policy as two areas where classes are difficult to find. “There’s all these great topics in the program, but it’s gotten really difficult to fill some of these clusters,” said Diaz.

Li and Diaz’s most pressing concern was the lack of tenure-track opportunities for Community Health professors. Currently, faculty are appointed through the School of Medicine in order to earn professorial titles, which they cannot receive on the undergraduate campus because they do not sit within a traditional department. In other programs such as International Relations or American Studies, professors receive their titles from and occupy tenure track positions within traditional departments.

Although this arrangement offers titles to Community Health faculty, it limits them from receiving tenure track positions and opportunities in the same ways as other professors on the undergraduate campus. “We are very aware that the status and resources that are allocated to you in academia because you have tenure track positions…are things that academics value and need,” said Diaz. “It’s hard to attract quality professors…if we can’t offer them back anything promising in return.”

Professor Martinez, the most recent professor to announce her departure, is leaving Tufts to take up a tenure-track position at Boston University. In an interview with the Tufts Daily in March, current Professor Cora Roelofs noted that, “When those scholars have options, a non-tenure track job at Tufts versus a tenure track job at another university, even if it’s not as desirable a university, is going to look more appealing…. Community Health is at a disadvantage by not offering a tenure track position.”

Li and Diaz added that in order to increase the diversity of course offerings within the program, more faculty will have to be hired. They worry that Tufts will not be able to attract and retain such faculty, noting that the public job posting for Professor Martinez’s replacement is currently listed a one-year position only. Axner further noted that it is imperative to focus on hiring professors of color, who are currently lacking in the program.

According to Dean Glaser, the faculty has been engaging in conversation about whether interdisciplinary programs should be able to make tenure track hires outside of traditional departments. “The pro argument is that there are some scholars that we may be missing by just hiring within disciplines,” said Glaser. “The main argument against it is that creating more small units is not efficient.… There are things inherent to small units that are, in my own personal view, problematic,” he added, suggesting that faculty members in these “small units” would be stretched thin with additional responsibilities.

Interdisciplinary education receives significant attention in Tufts’ T10 Strategic Plan. But Li and Diaz expressed frustration that in the energy for new programs, Community Health seems to have been overlooked. Referring to the Strategic Plan, Diaz said, “They say, ‘We’re looking forward to the future,’ but what do you mean the future? You already have this program that you could give resources to, and you’re not.”

Dean Glaser stressed that these decisions would take time. “We can’t just wave our hand over the situation…students have a shorter perspective than we do. They have a desire for a program to be a certain way…and they want to experience it. But we have to work within policies and within histories, and a lot of these things are highly political and require votes and persuasion and space and resources, and those things take time.”

To continue the conversation, Allen is holding a follow-up forum for students, where she will share information gathered from the first meeting and continue to solicit ideas from students.

Although Li and Diaz are both graduating, they are confident that student movement to expand Community Health’s stature and resources will continue into the fall. Current junior Becky Darin Goldberg is planning to push for a TCU Senate Resolution to show student interest in the program becoming a primary major.

“When it first started, the Community Health program was cutting edge,” said Daiz. “Tufts was one of the first, if not the first, to have an undergrad program.” Li added, “But when other schools are now giving professors tenure track positions and more resources…we’re not cutting edge anymore.”