Every year, more than 200 college students rotate through Tennessee’s Knox County Health Department, many of them future health workers hoping to put their classroom learning into practice.
“We want to create meaningful experiences for them,” APHA member Martha Buchanan, MD, the health department’s director, told The Nation’s Health. “When the students are here and providing input, they’re heard.”
Those experiences are thanks to an agreement with the University of Tennessee Department of Public Health known as an academic health department, an arrangement between health departments and academic institutions focused on enhancing public health education, research and services. The Tennessee collaboration is a two-way street — students get to experience the daily workings of a real health department, and staff from the health department lecture at the university and offer guidance to ensure the public health curriculum is graduating students ready to practice. Students who intern at the Knox County agency can come with their own project ideas, but they also get to take part in some of its most critical work, such as community health assessments and improvement planning.
When health departments and universities join together, public health students can gain on-the-job training. Dozens of such academic health departments exist in states around the country.
Photo by Nikada, courtesy iStockphoto
And the collaboration goes beyond the two public health counterparts. For example, Buchanan said the health agency is planning a project with the College of Engineering to standardize and streamline its screening and referral services. The agency also opens its internship slots to students in all kinds of majors, from medicine and nursing to engineering and law, which Buchanan said helps expand the kind of cross-sector understanding needed to advance health equity goals.
“Equity and the social determinants of health are such a challenge for all of us,” she said. “These are big problems that aren’t just for public health to address.”
While the Knox County Health Department is the first academic health department in Tennessee, it is one of dozens across the country and follows a long tradition of public health-academia partnerships. One of the earliest known literature references to an academic health department model was in the early 1930s and described a partnership between Johns Hopkins University and the Baltimore City Health Department. The two teamed to create the Eastern Health District, a small area in the university’s neighborhood where residents accessed clinical care, researchers studied public health problems and students got real-world training. Fast forward nearly a century, and there are more than 60 academic health departments “that we’re aware of, but we think the actual number is larger,” said Ron Bialek, MPP, president of the Public Health Foundation, which staffs and facilitates the Academic Health Department Learning Community, the first such forum of its kind.
Because there is no official designation or census of academic health departments and not all health departments that collaborate with academia identify as such, the exact number is hard to track. However, knowledge about the partnerships is growing, as is interest. For instance, the learning community, which began in 2011 to foster the expansion of academic health departments and swap best practices, now has nearly 900 individual members.
“When we first started this in 2011, no one was bringing these groups together,” Bialek told The Nation’s Health. “We didn’t know how many people would be interested when we started. But we hardly needed to generate interest — the interest just flooded in.”
Academic health departments place a high value on improving student skills as well as strengthening competencies among school faculty. The departments themselves also benefit.
Photo by Alvarez, courtesy iStockphoto
The Academic Health Department Learning Community has become an ideal space for studying such partnerships, documenting common characteristics and exploring their benefits. For example, a survey of the community published in 2016 in the Journal of Public Health Management and Practice found that 32 percent of academic health departments had been established for more than 10 years, 64 percent engaged in joint research, 92 percent placed a high value on improving student competencies and about half placed a high value on strengthening competencies among school faculty. The most frequently cited characteristics of such partnerships were collaborative education and training as well as joint research.
APHA member C. William Keck, MD, MPH, co-author of the study and chair of the Council on Linkages Between Academia and Public Health Practice, of which the learning community is an initiative, said in many ways, the academic health department is the public health equivalent of the teaching hospital for medical students.
Keck, who has authored articles on academic health departments, said while most of the research is still qualitative, versus quantitative, both health departments and schools report positive benefits. Keck advised people interested in forming an academic health department not to worry about following a particular approach, but to develop a partnership that fits their needs.
“We encourage people to think about this very, very broadly and not get too tied up in a tight definition of what an academic health department is,” he told The Nation’s Health.
The Lawrence-Douglas County Health Department and University of Kansas Center for Community Health and Development sit less than a mile apart, yet a 2011 community health assessment found the two entities were barely taking advantage of each other’s expertise and capacity.
Still, it was clear that the two organizations “had the bones of a great partnership, with shared goals and values,” said APHA member Vicki Collie-Akers, PhD, MPH, associate director for health promotion research at the university center. In turn, the two formed an academic health department in 2013 that is now on its third memorandum of understanding, taking it through 2019. The partnership is guided by three strategies: driving policy systems and environmental change to improve health, contributing to the public health evidence base, and building capacity within the current and future public health workforce.
Among its many projects, the collaboration is working to advance safe routes to school policies, according to Collie-Akers, who coordinates the academic health department on the university side. In particular, the center is leveraging its research skills and expertise to create a new methodology for understanding the impacts of safe routes to school, while the health department drives implementation efforts. The process is still underway, but she said collaborators are now developing a manuscript about their work intended to help fellow health departments advance safe routes in their own communities. In another project — an example of reaching across disciplines — the academic health department worked with the university’s School of Journalism to better understand community perceptions of the public health department and develop ways to rebrand its image as a driving force behind community health.
“We do find that having buy-in among institutional leadership and staff, particularly on the health department side, is really important and an ongoing process,” Collie-Akers told The Nation’s Health.
In Provo, Utah, the Utah County Health Department formalized its academic health department with Brigham Young University and Utah Valley University in 2009. The collaboration is focused on providing students with real-world experience and developing a robust evidence base for public health practice, said APHA member Eric Edwards, MPA, CHES, deputy director of the health department. And the fruits of the collaboration have been plentiful.
Student volunteers and interns have been instrumental in pulling off household hazardous waste collection events, recruiting residents to participate in indoor air quality and radon research, and training youth to advocate for tobacco control. In all, the department benefits from more than 8,000 intern hours each year. Edwards said while the agency had welcomed interns before creating an academic health department, the arrangement helped formalize the process and ensure students were paired with mentors who shared their interests.
In 2015, the Rhode Island Department of Health Academic Center launched, initially forming academic health departments with Brown University and the University of Rhode Island. Now, the center has affiliations with six of the state’s 11 universities and colleges — and the eventual goal is to collaborate with all 11, said Laurie Leonard, MS, director of the academic center. Leonard said the agency welcomes up to 150 students — or as they call them, scholars — each year, while about a dozen health department staff also serve as faculty at universities. Like fellow academic health departments, Leonard said the Rhode Island center takes an equity approach to its collaborations, seeking out student scholars across social determinant disciplines to bring into the public health fold.
“It’s really about sharing resources to achieve common goals,” she said.
Membership in the Academic Health Department Learning Community is free and open to anyone interested in academic health departments, said Kathleen Amos, MLIS, assistant director for academic-practice linkages at the Public Health Foundation.
“There’s no one right way to do this,” Amos told The Nation’s Health. “It’s about meeting the needs of your community.”
For more information, visit www.phf.org.
- Copyright The Nation’s Health, American Public Health Association
