Public Health 785: Selected Student Papers, 2020

February 2021

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.