Graduate students in the biostatistics course taught by Byron Jaeger, Ph.D. (far right) at the School of Public Health. Overall enrollment at the school rose 61% in 2020 from 2019.The COVID-19 pandemic has made unlikely celebrities of public health officers and epidemiologists and infectious diseases specialists. Millions of people now understand that public health practices save lives. And judging by the soaring numbers of applications at schools of public health nationwide, some significant fraction of those people have decided they want to learn how.
"It's no surprise that a worldwide pandemic created interest in the field of public health," said Paul Erwin, M.D., DrPH, dean of the UAB School of Public Health. The Association of Schools and Programs of Public Health reported that applications for master's and doctoral programs were up 23% in fall 2020 compared with fall 2019, which the association's CEO attributed in part to "the Fauci effect." At UAB, enrollment in the School of Public Health rose 61% in the 2020 calendar year compared with 2019, including a 92% increase in enrollment in the school's graduate programs in epidemiology.
These students arrived just as the school launched a major revision of the core curriculum for its popular master of public health (MPH) programs in fall 2020. The goal, Erwin said, is to “allow our graduates to immediately make an impact towards improving the public’s health.” The new curriculum also lets those students “witness first-hand how the research expertise of our faculty gets translated into cutting-edge programs and policies that support the health and well-being of our communities,” he added. The school’s faculty are leading the way in areas that are crucial to the future of public health, Erwin said, including communicating science to the public through social media and advancing data analysis to better plan for surges in patient volume that have overwhelmed health systems.
On a campus visit two and a half years ago, “I became touched by the School of Public Health’s motto to be somebody that strives to make a difference in their community and the lives of others,” said Haley Greene, who graduated in spring 2020 and now works as an applied epidemiologist at the Virginia Department of Health. “As a student, I was provided with the utmost support and resources to grow.”
The pandemic has affected the career plans of people who were already in public health programs, as well as new arrivals, Greene said. “I have noticed several public health students switch their interest in chronic disease to infectious disease along with an influx of individuals interested in public health careers,” she said. “I believe it is an exciting time for early-career public health professionals, as there are many opportunities now and into the future.”
Meet the students
Erika Austin, Ph.D., the school's associate dean for Academic Affairs (who has an MPH herself), says she is seeing three trends among new students. "There are students who are just now thinking of public health as an option because they have been made aware of it," she said. Another group of new students are “nurses or people who are in health care organizations or are in some way involved in the consequences of the pandemic,” Austin said. “In their applications, they are saying, 'I felt so helpless; our response was not what it needed to be and I want to improve my organization's capabilities’” — or their own. (See Application tips: What does public health mean to you?)
Current Master's of Public Health student Laura Fauss at the mass vaccination site in Columbiana County, Ohio, where she serves as operations chief. Image courtesy Laura Fauss."I'm also seeing a lot of students who are already working in public health or public health-adjacent fields who are coming back for more formal training," Austin said. Many people who work in state and local health departments do not have formal public health training, she explained. "Those are civil service jobs and that's how people tend to get into those positions," Austin said. "Now they are seeing, ‘I need a degree in this.’”
Laura Fauss has spent the past 16 years working in the environmental divisions of local health departments. Before the pandemic began, she was the division coordinator for drinking water and wastewater programs for the Columbiana County Health District in Lisbon, Ohio. “Now I have that position, along with being the public information officer for the county’s Emergency Operation Center and the operations chief for our mass vaccination drive-thru clinic,” Fauss said. Plus, one more thing: she’s working toward her master’s degree in public health at UAB with a concentration in environmental health.
“I was actually never interested in going back to school, but my new job duties and responsibilities inspired me — along with a mentor’s nudging — to look into MPH programs,” Fauss said. “In Ohio, most environmental director positions require a master’s degree, and all county health commissioner positions do. If I planned to advance my career, it was a necessity.”
Fauss started to research available programs and “UAB is one of the few schools that I found that offer an all-online MPH degree with the environmental concentration, which is what caught my eye at first,” she said. She signed up for a virtual open house, “where some of the professors spoke about the program and I was very impressed with their passion,” Fauss said. “This is the type of passion that teachers should have to inspire their students, and that I honestly needed to motivate me in an online schooling format while working full time. After that open house, UAB became my number-one choice.”
100% online and new core curriculum
The School of Public Health’s 100% online graduate programs have "no requirement for coming to Birmingham," Austin noted. Many students studying in-person opt to take some of their classes online as well. “We truly do have students who earn our degrees from all over the country and the world,” Austin said. “This year in particular we have a lot of international students pursuing their degrees from home."
"It's no surprise that a worldwide pandemic created interest in the field of public health," said Paul Erwin, M.D., DrPH, dean of the UAB School of Public Health. The field of public health is set to expand with new roles in the pandemic and post-pandemic eras, Erwin said.Whatever their motivation, new students in public health are benefitting from a core MPH curriculum that has been reconstructed based on the evidence-based public health model. Long before he became dean at UAB in August 2018, Erwin had played a national role in teaching evidence-based public health practice, based in part on his own experiences as a leader in regional health departments in Tennessee.
"We did a complete overhaul of our core courses that students in any MPH concentration will take," Austin said. "Instead of a course in epidemiology, followed by a course in biostatistics and so on, we have a series of courses offered sequentially in seven-week terms: starting with a community assessment, then quantifying the issue, developing and prioritizing program and policy options and then management and evaluation, followed by a capstone course that applies this to issues in environmental health.”
Students are challenged to find a real-life community health assessment, learn how the organization involved collected its data, analyze the strengths and weaknesses of its approach and outline how they might have approached the problem differently. "It's been a great time for it," Austin said, "particularly since we have so many students now who have state and local health department experience. We have asked them, ‘Is this how it works in the field?’ And they say, ‘Absolutely.’"
A changing public health workforce
The outlook for public health jobs is strong, fueled by pandemic-related awareness of understaffing and other shortcomings. President Biden's $1.9 trillion American Rescue Plan COVID relief package included funds for state and local health departments to expand their workforces, Erwin noted. The national Bureau of Labor Statistics revised its 2019-29 projections after the pandemic began, predicting 25% growth in epidemiology jobs during the current decade — the largest boost of any pandemic-related job forecast that the bureau made.
Ryan Buckman graduated from the University of Louisville with an undergraduate degree in public health in 2019 and immediately began working toward his MPH (with a concentration in epidemiology) at UAB. He graduated in spring 2021, with long-term career plans of working as a field epidemiologist, "preferably at the state or federal level," he said. He is now working for the California Department of Public Health in its Environmental Health Investigations Branch. "Seeing the role that epidemiologists have played in both the science of responding to the pandemic and communicating with the public, I feel inspired and have reaffirmed that this is the path I would like to take," Buckman said. He is not the only one. "I have had a lot of friends decide to get an MPH before pursuing other health-care degrees, and I think that this is a recent trend as people realize the importance that public-health understanding can bring to health care and society," Buckman said. He is not sure that the pandemic alone is responsible. “I believe the realization of what public health and understanding disease and prevention can do in society to identify health gaps may also be a contributor,” he said. “However, I do believe that this rise in popularity will continue to inspire interest and continued growth in the field."
Haley Greene was finishing her training in spring 2020, when the pandemic was perhaps at its most terrifying. All MPH students at UAB complete a semester-long internship before they graduate, and Greene was working with the Alabama Department of Public Health. “Before the COVID-19 pandemic, I focused on investigating the systems contributing to tick-borne diseases, in addition to looking at the acquisition of tick-borne disease in the state of Alabama to grasp seasonal and geographical patterns,” Greene said. In March 2020, she pivoted to become part of the ADPH COVID-19 response team in the department’s Infectious Diseases and Outbreaks Division. She interviewed patients with confirmed COVID-19 cases and conducted contact-tracing interviews. “I later transitioned to training ADPH’s district investigators on how to complete this process to delegate the task of conducting case investigations as the workload significantly increased.”
Today, Greene is working at the Virginia Department of Health through the prestigious Applied Epidemiology Fellowship from the Council of State and Territorial Epidemiologists and Centers for Disease Control and Prevention. “I primarily work on the foodborne disease epidemiology team in the Division of Surveillance and Investigation,” Greene said. “Due to the COVID-19 pandemic, I have also assisted with projects about COVID-19 response and general communicable disease investigations for health districts” across Virginia. For the past six months, Greene has been working on a project developing statewide methodology for differentiating persistently positive COVID-19 cases from SARS-CoV-2 reinfections using epidemiological investigation and laboratory data. “My colleague and I are looking forward to presenting our preliminary research for this study at the 2021 annual meeting of the Center for State and Territorial Epidemiologists this June,” she said.
Data analysis skills in demand
Erwin believes that public health professionals will find new roles beyond health departments in the post-pandemic world — in health care systems, for example. Since 2014, Russell Griffin, Ph.D., an associate professor in the Department of Epidemiology at UAB, has dedicated effort to conducting epidemiological surveillance and analyses with the Advanced Enterprise Analytics team in the office of the UAB Health System’s chief medical officer. That role includes surveillance of sepsis (a potentially fatal body response to infection); he also tracks ventilator-associated adverse events, the results of bacterial cultures for burn patients and the number of days patients spend on ventilators and assisted-breathing devices. “I really like the analytics work,” Griffin said. “I have always been into computers and coding since I was a kid, and this work lets me combine my love of biology/medicine, math and computing.”
As soon as COVID arrived in Alabama in March 2020, Griffin’s analysis projects shifted into overdrive. He began with a single report of the results of COVID-19 tests for patients and employees at the top of each hour. Since then, Griffin has expanded his analysis to include, among several other reports not detailed here:
- a twice-daily dashboard snapshot of the COVID-19 census in the hospital, including number of patients on ventilators by COVID status, demographics of COVID-positive patients, and counts of COVID-negative, COVID-confirmed and COVID-patient-under-investigation by type of nursing unit (acute care or intensive care);
- census data that is sent to the federal Department of Health and Human Services and the Alabama Department of Health to meet reporting requirements;
- prediction models of the hospital’s COVID census to guide surge planning;
- case lists tracking progress for patients enrolled in research trials, such as a treatment trial for monoclonal antibodies; and
- a twice-daily list of patients who have been discharged from the emergency department with a COVID test, and the result of the test.
Russell Griffin, Ph.D., an associate professor in the Department of Epidemiology, has dedicated effort to conducting epidemiological surveillance and analyses with the Advanced Enterprise Analytics team in the office of the UAB Health System’s chief medical officer since 2014. "Having people with those skills in health care is huge," Dean Erwin said. “Since December I have been assisting Dr. Gerald McGwin [professor of Epidemiology] and Jaye Locks [ambulatory services administrator in Employee Health] in overseeing vaccination efforts at Margaret Cameron Spain Auditorium as well as providing records of first- and second-dose vaccinations in the required message format to send to the Alabama Department of Public Health’s ImmPRINT system,” Griffin added.
"Having people with those skills in health care is huge," Erwin said. "Collecting, managing and analyzing big data will be increasingly important for health care systems." Pandemic planning was highlighted as a priority for years before the COVID-19 pandemic began; Erwin hopes the United States and the world will learn the lesson this time that prevention is far less costly than treatment and dealing with a pandemic.
Public health professionals may become key figures at institutions that never knew they needed anyone with that skillset on staff, Erwin adds. "One of the things we are seeing is hiring of public health-trained clinicians — not necessarily physicians —as health officers for academic institutions of all shapes and sizes,” he said. This past summer, Erwin’s undergraduate alma mater, Sewanee, asked him to assist in developing a job description for the university’s first-ever health officer. "I think this will increase as academic institutions realize that it is helpful to have people on staff with expertise in prevention and control and response to epidemics, whether that is COVID or an outbreak of strep throat on campus," Erwin said. "It's good to have someone with public health expertise."
The pandemic has revealed another type of professional, Erwin says: public health-trained communicators.
"One thing COVID-19 has made abundantly clear is that there is insufficient training and preparation in health communications, especially in high-risk, low-trust situations," Erwin said. He notes that several UAB faculty members, including epidemiologists Suzanne Judd, Ph.D., and Bertha Hidalgo, Ph.D., "have done really well with interview requests and media coverage.” (Both have been interviewed by television, print and online outlets from around the world.) "They have a knack for it,” Erwin said. “We need people who are trained to speak in health communications. This could open up a new area of academic preparation in schools.”
