Training the Next Generation Public Health Workforce

Rightly mentioned, given the current unpredictable public health challenges at hand, there is an urgent need to equip future public health professionals with not only theoretical scientific and technical skills but also with the competencies around critical thinking, adaptability, digital literacy, public health diplomacy, cultural understanding. Some good reads in this domain emphasizing on the essential skills required for training the next generation of the public health professionals are: 

Magaña, L., & Biberman, D. (2022). Training the Next Generation of Public Health Professionals. American Journal of Public Health, 112(4), 579–581. //doi.org/10.2105/ajph.2022.306756,  

Joshi, A., Bhatt, A., Gupta, M., Grover, A., Saggu, S. R., & Malik, I. V. (2022). The current state of public health education in India: A scoping review. Frontiers in Public Health, 10. //doi.org/10.3389/fpubh.2022.970617 , 

World Health Organization (n.d.). National workforce capacity for essential public health functions: Operational handbook for country-led contextualization and implementation. //iris.who.int/bitstream/handle/10665/376576/9789240091412-eng.pdf?sequence=1//iris.who.int/bitstream/handle/10665/376576/9789240091412-eng.pdf?sequence=1  

The importance of preparing the next generation of the public health workforce cannot be overstated, especially in the wake of global crises like COVID-19, climate change, and the rise in non-communicable diseases.

To ensure that future public health professionals are well-equipped, training programs must evolve beyond traditional classroom-based models. We need to integrate interdisciplinary education, experiential learning, and digital health competencies into curricula. According to the WHO (2021), a strong public health workforce should be adaptable, digitally literate, and culturally competent to meet emerging health challenges effectively.

Moreover, community-based training can bridge the gap between academic knowledge and real-world practice. Public health education should emphasize not only epidemiology and biostatistics but also skills in policy advocacy, risk communication, leadership, and systems thinking (Frenk et al., 2010). Collaborative learning and partnerships with local health systems can provide students with hands-on experience in solving complex public health problems.

Finally, investments in continuous professional development are crucial. Lifelong learning models help the workforce keep up with evolving health technologies, data systems, and global health trends. Supporting diversity, equity, and inclusion in training programs will also ensure that the workforce is representative and responsive to the communities they serve.

In summary, a forward-looking, skill-based, and community-engaged approach to education is essential for training a competent, resilient, and innovative public health workforce for the future.

References:

• Frenk, J., Chen, L., Bhutta, Z. A., Cohen, J., Crisp, N., Evans, T., ... & Zurayk, H. (2010). Health professionals for a new century: transforming education to strengthen health systems in an interdependent world. The Lancet, 376(9756), 1923–1958. //doi.org/10.1016/S0140-6736(10)61854-5

• World Health Organization. (2021). Roadmap for Public Health and Emergency Workforce. //www.who.int/publications/i/item/9789240037234

Changing demographics, globalization, technological developments, climate change, conflicts, increasing migration, shifting public opinions on the value of scientific evidence, influence of social media, a political arena that increasingly seems to focus on highlighting differences rather than looking for common ground: all these trends result in massive and complex societal challenges, which place great strain on our often underfunded and understaffed public health and health care services [1, 2]. In addition, the Pan-European Commission on Health and Sustainable Development, known as the Monti Commission, reviewed the evidence on the impact of the pandemic to formulate lessons learned and a call to action. They concluded that the COVID-19 crisis has reminded us of the vulnerability of societies, economies, and health systems, the weaknesses of our current systems of governance at national and global levels, and shone a light on the deep fault lines that exist in many societies [3]. The Lancet Commission on lessons for the future from the COVID-19 pandemic took an even more critical stance, finding ‘Widespread failures during the COVID-19 pandemic at multiple levels worldwide have led to millions of preventable deaths and a reversal in progress towards sustainable development for many countries’ [4, 5]. One issue that has been clearly highlighted by the pandemic is that a trained, motivated, and equipped public health workforce is essential [3]. Among the Lancet Commission recommendations is a call for ‘strong health education for health promotion, disease prevention, and emergency preparedness’ [4], while a recent European Centre for Disease Prevention and Control (ECDC) report makes the case for investment in the public health workforce with improvements and investment in preparedness planning and the need for a formalized decision-making and crisis management structure that supports intersectoral work, as well as increasing the capacities in risk communication and community engagement [6]. This illustrates that the workforce does not only have to be prepared for infectious disease outbreaks, but for all the societal changes that impact on population health as described above.

References

1. McKee M. The changing context of public health in Europe. Eur J Public Health 2019;29(Supplement_4):ckz185.510.

2 Wong BLH, Delgrange M, Nathan NL et al. The Association of Schools of Public Health in the European Region statement on the erosion of public health systems. Public Health Rev 2021;42:1604112.

3  Pan-European Commission on, Health and Sustainable Development. Rethinking policy priorities in the light of pandemics. A call to action [Internet]. Copenhagen; 2021. //www.who.int/europe/publications/m/item/rethinking-policy-priorities-in-the-light-of-pandemics—a-call-to-action

4 Sachs JD, Karim SSA, Aknin L et al. The Lancet Commission on lessons for the future from the COVID-19 pandemic. Lancet 2022;400:1224–80.

5 The Lancet. COVID-19 response: a massive global failure. Infographic [Internet]. The Lancet; 2022. //www.thelancet.com/infographics-do/covid-19-commission-2022

6 European Centre for Disease Prevention and Control. Lessons from the COVID-19 pandemic: May 2023. [Internet]. LU: Publications Office; 2023 [cited 2023 Jul 9]. //data.europa.eu/doi/10.2900/151256

The pandemic and societal challenges are a good reminder that we need to prepare students for jobs that have not yet been created, and for technologies that have not yet been invented, to solve problems that have not yet been anticipated. Several unprecedented challenges in past such as covid-19, environment crisis, economic struggles has highlighted many health inequities and the impacts of social determinants of health¹. Our ability to cope with uncertainty and rapid change has been tested. These challenges clearly exposed gaps in workforce preparedness, emphasizing the need to rethink and reform training programs to ensure resilience and effectiveness in future health emergencies.

The next generation of the public health workforce will need to strengthen the evolving technical and scientific competencies in public health, but, also, it will be crucial for them to develop human competencies such as resilience, curiosity, communication, cultural agility, empathy, compassion, flexibility, and the ability to cope with failure and rejection². There is extreme need in evaluating the academic curriculum, training sessions which are being developed to upskill and lay strong theoretical foundation for upcoming public health workforce so that they deliver essential public health functions (EPHF) at national and global level. 

References

1.Organization for Economic Co-operation and Development, Directorate for Education and Skills. The future of education and skills: education 2030. 2022.

2. Magaña L, Biberman D. Training the Next Generation of Public Health Professionals. Am J Public Health. 2022 Apr;112(4):579-581. doi: 10.2105/AJPH.2022.306756. PMID: 35319952; PMCID: PMC8961832.

Evidence suggests that half of the non-communicable diseases are preventable, yet there is a widening gap between lifespan and health span. There is an increase in life expectancy, but the last years are lived in poor health. This calls for population-level interventions by public health experts. The academic public health champions are required to prepare a workforce that can focus on Health Longevity. Focused efforts in research, practice, education, training, policy, and advocacy are some of the key components that can reduce this existing and widening gap. The 21st-century public health education requires embedding the curriculum on health longevity. There is also a need to define essential skills, knowledge required, and competencies attained by the students for this new curriculum. The inclusion of interdisciplinary learning, intergenerational learning, and community-engaged experiences can certainly prepare the workforce for this pressing public health issue. 

For more, read: ASPPH’s newly released report, Healthy Longevity: Public Health’s Next Frontier, a Framework for Research, Education, Practice, and Policy.

The complex nature of contemporary public health issues requires a multidisciplinary public health workforce, including professionals from various backgrounds who have been sensitized to the public health approach. In many countries, the field has traditionally been led by medical doctors who undergo further training in preventive branches of medicine such as epidemiology, hygiene, social medicine, biostatistics, or more recently, Global and One Health. Other countries have separate public health education programs independent of medical studies, offering various graduate and postgraduate courses. Over the years, efforts have been made to define the essential skills of public health professionals, led by organizations like the World Health Organization and the Association of Schools of Public Health in the European Region (ASPHER). These competencies continue to expand, necessitating more investment in public health infrastructure and training. The current lack of recognition, competitiveness, and appeal of a career in public health is leading to a restriction of the necessary build-up of qualified professionals. Many countries anticipate a shortage of public health workers due to an aging workforce, increased demand, and difficulties in attracting and training new professionals (3). The COVID-19 pandemic and severe climate events highlight the crucial role of the public health workforce in effective disaster management and preparedness, prompting decision-makers to take notice. It is the responsibility of the public health community to lead this effort and shape the future of the profession. Lessons from the last decades transfer to us several key points underlining the need for improved communication skills as well as the need for enhanced public health brokering roles for decision-makers and the general public.

References:

Aleksandar Stevanović, Tit Albreht, Mirjana Živković-Šulović, Mandić-Rajčević, S., Vesna Bjegović-Mikanović, & Željka Stamenković. (2024). Workshop of the Association of Public health: Towards the next generation of Public Health Workforce: Challenges and opportunities. 118–118. //doi.org/10.5937/batutphco24073s

The pandemic and other societal changes over the past two years have become a good reminder for Schools and Programs of Public Health (SPPH), "for jobs that have not yet been created, and for technologies that have not yet been invented, to solve problems that have not yet been anticipated" [2]. This has led to a turning point in the academic sector, where institutions immediately transitioned to remote learning to avoid disruptions in the learning process. The educational sector is starting to explore and envision a new way for educating the current and future generations across the world. A study from Plepys et. al. reflects that a minority of graduate students (17%) are currently working under the traditional governmental public health, but the pandemic has brought out a revitalized view for the governmental public health. So, with intentional actions and initiatives, this might change [3].

We must also equip students for a wider array of job opportunities [4], including the growing possibilities in healthcare and the private sector, alongside foundations and nonprofit entities. In the same vein, we should prepare them for the various responsibilities these positions entail and integrate skills from related areas, including resource and supply chain management from business, combating misinformation from communications  [5], advocacy, journalism, and media management, among others. The upcoming generation of the public health workforce will need to enhance their evolving technical and scientific skills in public health; however, it is equally important for them to cultivate human competencies such as resilience, curiosity, communication, cultural adaptability, empathy, compassion, flexibility, and the capacity to handle failure and rejection. Future employers will also seek capabilities in critical thinking, problem-solving, creativity, adaptability, collaboration, teamwork, emotional intelligence, self-regulation, digital literacy, and the ability to engage with diverse populations. Additionally, [2,6] SPPH will need to perpetuate a commitment to the values of our field: valuing diversity, ethical practice, and a refusal to accept injustice and inequities.

References:

1. Magaña, L., & Biberman, D. (2022). Training the Next Generation of Public Health Professionals. American journal of public health, 112(4), 579–581. //doi.org/10.2105/AJPH.2022.306756

2. Organization for Economic Co-operation and Development, Directorate for Education and Skills. The future of education and skills: education 2030. 2022.  //www.oecd.org/education/2030/E2030%20Position%20Paper%20(05.04.2018).pdf

3. Plepys CM, Krasna H, Leider JP, Burke EM, Blakely CH, Magaña L. First-destination outcomes for 2015–2018 public health graduates: focus on employment. Am J Public Health. 2021;111(3):475–484. doi: 10.2105/AJPH.2020.306038.

4. Galea S, Vaughan R. Preparing the public health workforce for the post–COVID-19 era. Am J Public Health. 2021;111(3):350–352. doi: 10.2105/AJPH.2020.306110.

5. Ghaffar A, Rashid SF, Wanyenze RK, Hyder AA. Public health education post-COVID-19: a proposal for critical revisions. BMJ Glob Health. 2021;6(4):e005669. doi: 10.1136/bmjgh-2021-005669.

6. McKinsey & Company. 2021.  //www.mckinsey.com/industries/public-and-social-sector/our-insights/defining-the-skills-citizens-will-need-in-the-future-world-of-work