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Underfunded And Under Threat

Public Health Programs See Surge in Students Amid Pandemic

University of Illinois student Sarah Keeley (right) keeps her distance on the Urbana campus Oct. 6. When the coronavirus emerged in the news in January, Keeley was working as a medical scribe and considering what to do with her biology degree. In August, she began studying to become an epidemiologist. (AP Photo/Charles Rex Arbogast)

As the novel coronavirus emerged in the news in January, Sarah Keeley was working as a medical scribe and considering what to do with her biology degree.

By February, as the disease crept across the U.S., Keeley said she found her calling: a career in public health. 鈥淭his is something that鈥檚 going to be necessary,鈥 Keeley remembered thinking. 鈥淭his is something I can do. This is something I鈥檓 interested in.鈥

In August, Keeley began studying at the University of Illinois at Urbana-Champaign to become an epidemiologist.

Public health programs in the United States have seen a surge in enrollment as the coronavirus has swept through the country, killing more than 246,000 people. As state and local public health departments struggle with unprecedented challenges 鈥 slashed budgets, surging demand, staff departures and even threats to workers鈥 safety 鈥 a new generation is entering the field.

Among the more than 100 schools and public health programs that use the common application 鈥 a single admissions application form that students can send to multiple schools 鈥 there was a 20% increase in applications to master鈥檚 in public health programs for the current academic year, to nearly 40,000, according to the Association of Schools and Programs of Public Health.

Some programs are seeing even bigger jumps. Applications to Brown University鈥檚 small master鈥檚 in public health program rose 75%, according to Annie Gjelsvik, a professor and director of the program.

Demand was so high as the pandemic hit full force in the spring that Brown extended its application deadline by over a month. Seventy students ultimately matriculated this fall, up from 41 last year.

鈥淧eople interested in public health are interested in solving complex problems,鈥 Gjelsvik said. 鈥淭he COVID pandemic is a complex issue that鈥檚 in the forefront every day.鈥

It’s too early to say whether the jump in interest in public health programs is specific to that field or reflects a broader surge of interest in graduate programs in general, according to those who track graduate school admissions. Factors such as pandemic-related deferrals and disruptions in international student admissions make it difficult to compare programs across the board.

Magnolia E. Hern谩ndez, an assistant dean at Florida International University鈥檚 Robert Stempel College of Public Health and Social Work, said new student enrollments in its master鈥檚 in public health program grew 63% from last year. The school has especially seen an uptick in interest among Black students, from 21% of newly admitted students last fall to 26.8% this year.

Kelsie Campbell is one of them. She鈥檚 part Jamaican and part British. When she heard in both the British and American media that Black and ethnic minorities were being disproportionately hurt by the pandemic, she wanted to focus on why.

鈥淲hy is the Black community being impacted disproportionately by the pandemic? Why is that happening?鈥 Campbell asked. 鈥淚 want to be able to come to you and say 鈥楾his is happening. These are the numbers and this is what we鈥檙e going to do.鈥欌

Florida International University student Kelsie Campbell, a biochemistry major, says she plans to explore why Black and ethnic minorities are being disproportionately hurt by the pandemic when she begins her master鈥檚 in public health program at Stempel College in the spring. 鈥淭here鈥檚 power in having people from your community in high places, somebody to fight for you, somebody to be your voice,鈥 she says.(AP Photo/Wilfredo Lee)

The biochemistry major at Florida International said she plans to explore that when she begins her MPH program at Stempel College in the spring. She said she hopes to eventually put her public health degree to work helping her own community.

鈥淭here鈥檚 power in having people from your community in high places, somebody to fight for you, somebody to be your voice,鈥 she said.

Public health students are already working on the front lines of the nation鈥檚 pandemic response in many locations. Students at Brown鈥檚 public health program, for example, are crunching infection data and tracing the spread of the disease for the Rhode Island Department of Health.

Some students who had planned to work in public health shifted their focus as they watched the devastation of COVID-19 in their communities. In college, Emilie Saksvig, 23, double-majored in civil engineering and public health. She was supposed to start working this year as a Peace Corps volunteer to help with water infrastructure in Kenya. She had dreamed of working overseas on global public health.

The pandemic forced her to cancel those plans, and she decided instead to pursue a master鈥檚 degree in public health at Emory University.

鈥淭he pandemic has made it so that it is apparent that the United States needs a lot of help, too,鈥 she said. 鈥淚t changed the direction of where I wanted to go.鈥

These students are entering a field that faced serious challenges even before the pandemic exposed the strains on the underfunded patchwork of state and local public health departments. An analysis by AP and KHN found that since 2010, per capita spending for state public health departments has dropped by 16%, and for local health departments by 18%. At least 38,000 state and local public health jobs have disappeared since the 2008 recession.

And the workforce is aging: Forty-two percent of governmental public health workers are over 50, according to the de Beaumont Foundation, and the field has high turnover. Before the pandemic, nearly half of public health workers said they planned to retire or leave their organizations for other reasons in the next five years. Poor pay topped the list of reasons. Some public health workers are paid so little that they qualify for public aid.

Brian Castrucci, CEO of the de Beaumont Foundation, which advocates for public health, said government public health jobs need to be a 鈥渄estination job鈥 for top graduates of public health schools.

鈥淚f we aren鈥檛 going after the best and the brightest, it means that the best and the brightest aren鈥檛 protecting our nation from those threats that can, clearly, not only devastate from a human perspective, but from an economic perspective,鈥 Castrucci said.

The pandemic put that already-stressed public health workforce in the middle of what became a pitched political battle over how to contain the disease. As public health officials recommended closing businesses and requiring people to wear masks, many, including Dr. Anthony Fauci, the U.S. government’s top virus expert, faced threats and political reprisals, AP and KHN found. Many were pushed out of their jobs. An ongoing count by AP/KHN has found that more than 100 public health leaders in dozens of states have retired, quit or been fired since April.

Those threats have had the effect of crystallizing for students the importance of their work, said Patricia Pittman, a professor of health policy and management at George Washington University鈥檚 Milken Institute School of Public Health.

鈥淥ur students have been both indignant and also energized by what it means to become a public health professional,鈥 Pittman said. 鈥淚ndignant because many of the local and the national leaders who are trying to make recommendations around public health practices were being mistreated. And proud because they know that they are going to be part of that front-line public health workforce that has not always gotten the respect that it deserves.鈥

Saksvig compared public health workers to law enforcement in the way they both have responsibility for enforcing rules that can alter people鈥檚 lives.

鈥淚 feel like before the coronavirus, a lot of people didn鈥檛 really pay attention to public health,鈥 she said. 鈥淓specially now when something like a pandemic is happening, public health people are just on the forefront of everything.鈥

KHN Midwest correspondent Lauren Weber and KHN senior correspondent Anna Maria Barry-Jester contributed to this report.

This story is a collaboration between The Associated Press and KHN.

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