The Evolution Toward Accreditation

The Council on Education for Public Health (CEPH) was established in 1974 to accredit schools and programs of public health, primarily those at the graduate level. For the field, it provides assurance for students, employers, and the public that educational programs meet national standards. For nearly 40 years, the MPH degree has been the recognized entry-level professional degree in the field of public health. However, other public health specialized degrees, particularly those in community health education, environmental health, and health administration have existed at the baccalaureate level for many years. These degrees continue to prepare graduates for certain specialized positions in public health. Accreditation in public health allows educational programs to participate in certain federal funding opportunities, provides them with a marketing advantage to potential students, and provides graduates with opportunities for certain governmental fellowships and jobs. Over the last decade, undergraduate majors in public health have become increasingly popular. This popularity is seen both at universities with accredited graduate schools or programs in public health, as well as in liberal arts and other types of higher education institutions. A 2008 survey conducted by the Association of American Colleges and Universities, founded in 1915 to represent liberal arts colleges, indicated that 137 of its 837 members, or 16%, offer majors or minors in public health (1). While these numbers represent the most recent official survey data, anecdotal evidence suggests that the number of existing programs today may number as many as 500. These programs have become wildly popular majors for students and attractive to many universities as revenue generators in difficult economic times. Johns Hopkins University has offered an undergraduate major in public health studies since 1976. There were 159 majors in 1998 and 311 majors in 2008. It remains one of the university’s most popular undergraduate majors, currently producing between 110 and 150 graduates per year. At William and Mary, a freshmen seminar on emerging diseases is so popular that it has to be offered in two sections each semester and fills up instantly (1). In 2009, The Chronicle of Higher Education identified public health as one of the five most “up-and-coming majors” likely to be developed at colleges and universities in the coming years (2). With the growing popularity of and interest in undergraduate public health came an expanded view of what was considered “public health” at colleges and universities around the country. Public health has long been a profession that has benefited from knowledge and expertise contributed by a variety of professions (e.g., medicine, law, business, and social work) and numerous disciplines (e.g., psychology, sociology, and anthropology). Many faculty from these disciplines and professions have applied their expertise to health and health-related questions throughout their careers. On the other hand, few faculty trained in public health find academic homes outside graduate-level public health programs and are unlikely to be found on undergraduate campuses. As such, emerging undergraduate public health majors were of varying foci and tended to reflect existing faculty expertise within the university. Faculty were looking to national organizations, including CEPH, the Association of Schools and Programs in Public Health (ASPPH), and the American Public Health Association (APHA) for guidance on what should be included in the majors they had been asked to develop and seeking a mechanism for quality assurance. Ongoing conversations among public health academicians revealed a growing unease about the purpose of the undergraduate major in public health. Should students prepared in public health at the undergraduate level be entry-level public health practitioners? Should they be preparing for further professional education in public health or a related profession? In some states, demand is high for entrylevel public health professionals trained at the undergraduate level. In certain public health specialty areas, such as community health education, sanitation, and health administration, entry-level practitioners have traditionally been trained at the baccalaureate level. In other areas of the country, and in some employment settings, employers prefer master-level training. Further concern was expressed that the development of undergraduate training in public health would lower the professional bar – that individuals trained at the baccalaureate level would squeeze out MPH graduates in difficult economic times. All these issues converged around the question of whether an accreditation mechanism should be developed for baccalaureate programs in public health. To determine whether to develop an accreditation system for baccalaureate-level public health programs, the Council, CEPH’s decision-making body, considered