Academic journal article Public Health Reviews; Rennes

Public Health Education in Europe: Old and New Challenges

Academic journal article Public Health Reviews; Rennes

Public Health Education in Europe: Old and New Challenges

Article excerpt


According to current estimates,1 there are about 450 schools of public health worldwide, not counting departments or units providing specific courses, or training devoted to epidemiology, social medicine, technology assessment, environmental medicine, etc. According to estimates from the European Association of Schools of Public Health (ASPHER), over 80 institutions in the European region qualify as schools of public health.2

The purpose of this article is to discuss some of the current issues in the development of European schools of public health, to draw on lessons from the past, and to address the central, future challenges of academic public health in the European region.


Public health is defined here using Winslow's definition which says that "(public health is) the science and art of preventing disease, prolonging life, and promoting physical health and efficiency through organized community efforts for the sanitation of the environment, the control of community infections, the education of the individual in principles of personal hygiene, the organization of medical and nursing service for the early diagnosis and preventive treatment of disease, and the development of the social machinery which will ensure to every individual in the community a standard of living adequate for the maintenance of health."3 A shorter definition simply states that public health is about providing appropriate answers to the needs of the population.

Education and training are defined here as the formalized transmission of knowledge and skills related to the disciplines of public health, directed towards workforce involved in public health, provided by qualified teachers and senior practitioners, and following the standards of "best practices" from leading centres around the world. Where academic education and training is concerned, the transmission includes the latest advances from the research field, in which all academic teachers should be deeply involved. The main aim of education and training is to anchor the decisions made by public health practitioners in scientific evidence.

The public health workforce is a part of the available human resources for health promotion and maintenance. This group is usually classified into two sections: those providing direct care for individuals and those providing non-personal health services.4 The latter is a synonym for the public health workforce, i.e., workers whose prime responsibility is the provision of core, non-personal public health activities, irrespective of their organizational base (i.e., within or outside a public health institution).

Most of this workforce is involved in the practice of public health, defined as the appropriate use of available knowledge. A more complete definition states: "public health practice is the strategic, organized and interdisciplinary application of knowledge, skills and competencies necessary to perform essential public health services and other activities to improve the population's health."5 This is close to the definition of the field epidemiologist provided by the European Centre for Disease Prevention and Control: "(someone who) applies the science of epidemiology to the prevention and control of public health problems and works in intervention and response activities."6

These definitions do not truly reflect the strong interactions between education, research and practice. Astute observations in the field of public health can be an inspiring start for an increase in the analytic and deductive capacity of both practitioners and researchers to identify uncharted areas deserving further exploration. In fact, if the goal is evidence-based public health practice, it should be firmly anchored in the best available cumulative experience from research and practice.7 Accordingly, a well-functioning public health system aims to maintain continuous interaction between education and training, research and development, and skilled practice. …

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