As part of an effort to ensure high-quality public health training, the Council on Education for Public Health (CEPH) revised its 2016 accreditation standards. In response, the MPH Program at the University of Wisconsin School of Medicine and Public Health in 2019 introduced a new curriculum to better meet the needs of the public health workforce. One of the required core courses focused on including competency goals in Public Health & Health Care Systems.
The MPH Program asked faculty at the Center for Patient Partnerships to design a course to train MPH students in these areas of competency. The course, Medical Care and Public Health Systems, offers an overview of the organization, finance, and delivery of medical care services and public health in the United States.
More than training students to become “experts” in each of these ever-changing areas, we designed a course to train students in systems thinking and analysis. By boosting their understanding of underlying goals and contradictions within systems that influence health, we train them to ask more impactful questions about research, policy, and practice. They then increase their ability to approach complex public health and health care policy problems armed with evidence and insight.
We start the course with a review of key historical events that led to our current system of medical care and public health. Students learn that specific events, often called “accidents of history,” actually reflect many unresolved, underlying tensions that existed even prior to the founding of the United States. It turns out that these “accidents,” like tying health insurance to employment status after World War II, or many of the patterns we see emerging during the COVID-19 pandemic, weren’t really accidents at all. Many patterns are predictable, especially when viewed through a lens of systems thinking.
Examples of underlying tensions include notions of “the deserving and undeserving poor,” the disconnect between individual rights and the collective good, and debates over appropriate roles of government, which in the United States has resulted in a woefully underfunded and unrecognized public health infrastructure. These tensions, along with the underlying beliefs and values they reflect, emerge repeatedly throughout the systems we analyze in the course.
One of the assignments we developed for this course was a “systems analysis” of a complex public health problem. In the course, we define a complex problem as one whose causes interact in ways we may not fully understand, involved many interests with often competing goals.
This compendium of selected student papers offers insights into their growing systems perspectives. We publish it in honor of their commitment to taking on complex problems in public health, and we showcase their work to future students who demonstrate that same spirit of commitment.
Mary Michaud, MPP
Faculty Associate, La Follette School of Public Affairs
Sarah Davis, JD, MPA
Clinical Associate Professor of Law
Many thanks to Bailey Griffin, who assisted with producing this compilation.
Compendium of selected MPH student papers: Public Health 785, Spring 2020
- LGBTQ Youth Homelessness and Discrimination in the Foster Care System (PDF)
Julia Alberth, Dual MD-MPH Expected 2024
- The Influence of Healthcare Systems Factors on Racial Disparities in Diabetes Care Barriers Faced by African American Patients in Access to Care and Patient-Provider Relationships (PDF)
Mackenzie Andropolis, MPH/MPAS Dual Degree Expected 2022
- How do Housing and Urban Development and Medicaid Support Low-Income, Older Adults to Age in Place? A Systems Analysis (PDF)
Laura Block, PhD in Nursing Expected 2024
- Effects of Housing on Health and Wealth Among Low-Income Families in Milwaukee, Wisconsin (PDF)
Korina Hendricks, MPH Expected 2021
- A Critical Evaluation of Pregnancy Intendedness as a Public Health Metric (PDF)
Erin Curtis Nacev, MD/MPH Expected 2021
- Systems Change: Diabetes Prevention in Latino/Hispanic Communities (PDF)
Markayle Schears, MPH Expected 2021, MD expected 2025
- Reducing Unintended Pregnancy Among Foster Youth in Wisconsin (PDF)
Hannah Sherfinski MPH Expected 2021
- An Epidemic of Violence: A Public Health Crisis in Honduras (PDF)
Eileen Stillwell, MPH Expected 2021
- Impacts of Healthcare Reform Platforms on Children with Special Healthcare Needs (PDF)
Brittany St. John, OTR | MPH and PhD Expected 2022
- Narratives Surrounding Long-Acting Reversible Contraceptives (LARC) in Medicine, Public Health and Social Policy (PDF)
Mireya Taboada MPH and MD Expected 2021
- Nowhere to Go, No One to See: Breaking Down Barriers to Long-Acting Reversible Contraception Among Badgercare Recipients in Rural Wisconsin (PDF)
Molly Wight, MPH Expected 2021