Retrospective/Health Without Boundaries: Agendas for Action

A retrospective of the past decade at HSPH.

 

INTRODUCTION

The last decade has witnessed profound and novel threats to the public's health: the emergence of deadly new infections such as SARS and the H5N1 influenza virus; 9/11 and the specter of bioterrorism; the spread of drug-resistant pathogens; a steep rise in obesity, diabetes and related chronic afflictions; widening disparities between rich and poor. All these trends represent health and social problems compounded by the forces of globalization. Against this backdrop have unfolded revolutions in technology, genetics/genomics and communications — an explosion of knowledge that, when properly harnessed, could turn back many of the scourges of our time.

The Harvard School of Public Health - since 1922, the world's most dynamic and rigorous public health research and teaching enterprise — is strategically positioned to meet the health challenges of the new century. Under the leadership of Dean Barry R. Bloom, it has boldly upgraded its mission and structure, building a firm scientific, educational and financial platform for the future. Responding to rapid advances in technology and deepening health crises, the School has envisioned and created entire new departments and programs in order to address ever-evolving health threats. And HSPH has vaulted intellectual and geographic boundaries, embracing an interdisciplinary emphasis on genes and the environment, quantitative health sciences and bioinformatics, and global health.

Under Dean Bloom, who assumed leadership on January 1, 1999, the School has sustained its tradition of major contributions to the field's concepts and methodologies. Its scientists have unraveled key mechanisms of obesity-related metabolic syndrome and drug-resistant malaria. They have modeled the course of emerging

infections and hospital outbreaks. HSPH helped catalyze the visionary Public Health Foundation of India, and nurture the ambitious Botswana HSPH AIDS Initiative Partnership to enhance AIDS research, prevention and treatment. Just as crucial, the School has continued to inform public health policy, from government smoking bans and environmental regulations to statutes eliminating trans fats from restaurants and requiring its labeling on food products. And HSPH is unique among its peers in having had four of its current faculty awarded MacArthur "Genius" grants.

This small sample of achievements speaks to the School's leadership in public health education and discovery. In contrast to faculties traditionally structured around disciplines, professions, skills, or sectors (all of which are emphasized at the School), HSPH is at heart organized around solving problems and addressing threats to the public's health and well-being. With its long-standing mission of deterring global disease, focused particularly on poor and disadvantaged populations, it brings new ideas to the frontlines of practice. By putting a premium on prevention, it underscores an approach that has again and again proven cost-effective, both in human and financial terms. By training public health leaders and strengthening public health institutions nationally and internationally, it lays the groundwork for lasting change.

To encompass the School's broad scope of activity and help it contend with future threats, HSPH deans and department chairs recently created a planning matrix, which frames the School's strategies for the next 20-50 years. One dimension of the matrix represents the determinants of population health for the present and foreseeable future: environmental, biological, social, and policy. The other dimension represents public health problems that the School is committed to addressing: infectious diseases; chronic diseases; avoidable environmental threats, injury and violence; health disparities; and health systems. Far-reaching and practical, this matrix will enable the School to respond nimbly and effectively to both endemic problems and unexpected public health emergencies.

To make progress on this ambitious set of agendas, the School relies on the disciplinary strengths of its departments and divisions. It has sought to integrate these disciplinary approaches with its public health vision. Investments of School resources stimulate interdisciplinary research, and planning for a campus in Allston will allow the use of physical configuration to further support academic interactions.

The School has also reinvigorated its educational mission. A revised curriculum is in development that revolves around active learning, case-based teaching, problem-solving, and greater attention to the needs of students. Over the past decade, student financial aid has increased six-fold, attracting the very top tier of applicants. This growth in support has been made possible by the generosity of numerous donors to the School and the University as well as an increase in endowment payout.

The School's many successes over the past ten years under Dean Bloom — a distinguished immunologist and global health authority — have built a firm foundation for future discovery and policy change. An institution that has shaped the field for nearly nine decades, the Harvard School of Public Health continues to provide vision, influence and leadership in one of humankind's most urgent pursuits.

This text is from a retrospective that will be available fully on the School's home page on Friday, June 6.

Related article: Milestones at HSPH, 1999-2008 

—Madeline Drexler. Photo by Richard Friedman.