With the recent pandemic, public health has been getting a lot of attention.
Many students are now considering whether a career in public health is for them or not.
Having done a public health degree, it can be tricky to advise people without being biased to the benefits of the discipline.
In this post, however, we are focusing on the negatives of studying public health.
A lot of people still don’t know exactly what it is so this seems like a good place to start.
What is public health?
Public health has had a number of different definitions over the years.
The biggest issue with defining public health is the vague descriptions that are always provided.
This is often due to the vast amount of topics covered in any public health course.
Simply put, public health is the science of preventing disease and injury at a population level.
This may be as complicated as analysing trends and statistics for new infectious diseases, or as simple as planning regular football tournaments to improve cardiovascular health within a community.
The history of public health is one that is filled with grief, suffering, and a curious interest in the health of society.
Brief history of public health
Hippocrates (400BC) was the first to observe the effects of seasons, changes in weather, and water quality on public health. He however didn’t do any enumerations to begin calculating prevalences.
He is also recognised as the “father of medicine” for his contributions to clinical observations, predicting the development of disease, and formation of humoral theory.
John Graunt (1600 AD) was a businessman, But his passion was studying the health of the population.
Often referred to as the first demographer, he quantified baptisms as a marker of birth, and burials as a marker for death.
This is because, in those days, parish data was the only place where such data was collected and kept.
They were not 100% accurate, but they were all he had!
He noticed that there were peaks of burials occurring almost cyclicly.
These were actually deaths coinciding with the plague, caused by Yersinia Pestis.
John Graunt did what Hippocrates didn’t. He enumerated data and formed links between disease and prevalence data which forms the building blocks of epidemiology.
Edward Jenner is another famous figure in public health who lived between 1749 and 1823.
He was an English physician who pioneered the use of vaccines against viral infections.
Back in his time, smallpox was an infection that killed a large population of people at once.
He however noticed that the milkmaids who worked with cows seemed protected against the often deadly reaction to contracting smallpox.
He carried out a rather bold experiment to test his hypothesis that cows were giving the milkmaids immunity to smallpox.
Jenner inoculated a child with the pus from a blister caused by cowpox and discovered he became immune to smallpox as a result.
This was an incredibly notable discovery that would change the future of medicine and help spawn the entire field of immunology and vaccine development.
William Farr (1807) was the chief statistician in charge of analysing all public health data in the UK.
Farr was responsible for analysing vast amounts of data and performing statistical calculations, often by hand!
Farr was able to use the data collected to calculate and estimate expected further life years at birth, and at other age ranges, granted the person lived up to that age.
For example, he was able to calculate that at birth, the average life expectancy of men is 41, and 42 for women. This was in the year 1841!
If someone managed to live till 55 however, they would have further expected life years of 30 for men, and 32 for women.
Farr was able to use data from the national register of deaths in 1841 for his numerators, and his denominators were extracted from the 1841 census, which would enumerate the total population of the UK at the time.
John Snow was also an English physiologist like Edward Jenner, living between 1813 and 1858.
John Snow is often credited as one of the founders of modern epidemiology because of his role in disease prevention and the recognition of infection trends.
John Snow was able to trace the source of a cholera outbreak in London to one water pipe. He then reduced infection spread by removing the handle.
He discovered the problematic pump by talking to residents and studying the patterns of disease in the surrounding areas.
His discovery is often hailed as a pivotal moment in modern medicine and epidemiology as it challenged now obsolete theories such as miasma theory.
The Boston university site has very good resources on public health’s history.
Public health has numerous disciplines and aspects that make it somewhat difficult to explain in one go, and even trickier to study in one year.
What to expect in a public health MPH degree
It is usually easier to break down what you can expect in a public health degree by each discipline.
Statistics is a fundamental aspect of science in general. It just happens to also be very important in public health.
Statistics is the study of probability analysis and the interpretation of data.
Public health often involves collecting vast amounts of data for research, surveillance, routine analysis, health policy analysis or epidemiological analysis.
Raw data is often almost meaningless in its natural form.
Statisticians can however perform a wide array of functions, transformations and calculations on any dataset to make the data much more useful in solving a problem.
Every public health degree will likely feature statistics heavily in their curriculum.
For those who choose to specialise in statistics, you will be met with several in-depth exams about deep statistical theory, and its practical application in research.
this includes things like regression analysis, variability and agreement, diagnostic test analysis, ANOVA, factor analysis and much more analytical techniques. The exams are likely to involve essays, MCQs and short answer questions.
The formal definition of epidemiology is:
Study of distribution and determinants of health-related states or events in specified populations, and the application of this study to the control of health problems. Or in shorthand, who has what, where, and why?CDC.gov
Studying epidemiology as part of your public health degree can be challenging!
The course is set up to cover the major aspects of public health, however, because epidemiology is such a big aspect of the curriculum, students often find that it’s the module they struggle with the most.
Epidemiology is somewhat of a mix between demography, geography, and statistics.
The hardest part to wrap your head around is all the definitions!
Each epidemiological term has a specific definition and possibly an associated mathematical formula.
At least you don’t have to remember all by heart, however, to excel at epidemiology and public health, you will need a solid grasp of all the epidemiological terms and how they relate to each other.
You may also need to commit several maths formulas to memory such as odds ratio calculations, relative risk, attributable risk, prevalence, incidence rate, and also understand the difference between these.
Health policy is all about developing plans to achieve a certain healthcare goal.
This could be policy relating to the reduction of alcohol consumption, or the spread of a viral infection.
As you can imagine, lots of careful planning and investigation must take place before implementing a policy that may affect many people.
Often a proposal is made, with key stakeholders mentioned.
Research is commissioned over a time period and data is analysed to test whether fully deploying the policy will have positive impacts on healthcare.
This ensures proper management of resources and avoids policies that are proved to be ineffective.
Minimum unit pricing for alcohol is an example of a healthcare policy that has been tested and shown to work in different geographical locations.
Global health or global public health is all about addressing public health concerns on a worldwide level.
The WHO is an example of an organisation that takes global public health seriously.
They often deal with environmental concerns, communicable and non-communicable disease burden, and the emergence of global pandemics.
There are usually many more sub-disciplines!
Depending on which university you go to or which speciality track you pick, you will have even more options to choose from!
Reasons why you shouldn’t study a public health MPH degree
We have established a little bit of the background behind public health.
While public health itself isn’t inherently bad, public health degrees might be.
Many institutions offer public health degrees however very few fail to teach students the fundamentals of public health that will help them get jobs in the future!
Some degrees may focus too much on one aspect of public health while neglecting other important aspects. Other degrees may be too vocationally driven, with a failure to deliver on more theoretical aspects of the discipline.
Regardless, the resultant student’s knowledge is usually unbalanced, reducing the chance that they will be great public health experts in the future.
Let’s explore some common reasons why you may choose to avoid studying public health.
The course content isn’t what you’d expect
Many students may go into a public health degree expecting to learn about how to take care of the public or manage pandemics, healthcare disasters and human rights crises.
Unfortunately, there are numerous aspects of public health and many students will find themselves learning core modules that they aren’t very interested in.
For example, if you enrolled on a public health degree to study global public health, you might find the epidemiology or statistics content very unappealing, boring, and time-consuming.
But since these modules are often core modules, it is compulsory to study these along with your interests.
Another way course content may be unexpected for public health students is by how detailed it may be.
The history of public health for example is one that is rich with anecdotes and scientific information. It is often required to learn this vast history and deliver presentations on your favourite parts!
In essence, you might not always enjoy what you are studying, and it might not be as fun as you imagined.
The lectures are boring and prolonged
As mentioned before, public health topics can be rich with numerous details and factual information.
These often can make it very tricky to convey all this information in a short presentation.
As a result, public health lectures are either incredibly dense with information, and delivered over a short period of time, or very lengthy and delivered over a period of 2 hours or more.
Furthermore, depending on the lecturing style and the specific topic, the delivery of public health lectures can be very boring!
This can seem strange since public health is actually a very interesting field!
unfortunately, learning about public health and working within the field are two very different things.
Sitting behind a screen listening to how to create the best questionnaire or how to calculate positive predictive value can seem interesting, however at the moment, such tasks are mind-numbing.
Of course, if In-person lecturing resumes, this will make students of public health learn better, and have a more engaging experience.
Public health is best learnt in person, and with the aid of student-teacher interactions!
Therefore, when given the choice, you should always try to study public health in person rather than online or through a distance learning program!
You will have a far more engaging experience which will hopefully make the boring parts more bearable!
There’s an annoying amount of maths involved
Students may or may not expect this, but when doing a degree in public health, a significant amount of maths will be encountered.
This maths is usually due to the number of statistics and epidemiology taught as compulsory modules!
If you enjoy maths and elect to study additional modules like health measurements, RCTs and regression analysis, you will get more than your fair share!
Something as simple as a sample size calculation could take the whole day to learn!
On the other hand, basic statics like averages, skew, and graphical interpretation could be something you’re already familiar with.
Nevertheless, this doesn’t change the fact that if you’re not strong in maths, you’ll certainly struggle with some public health modules!
Even for a strong mathematician, certain unfamiliar topics like factor analysis, diagnostic test calculations, and epidemiological curve interpretation might prove tricky!
In the future, we will release more content on public health that is severely lacking on YouTube, so stay subscribed to the channel!
Not enough clear career guidance
This may not be the fault of the institutions since clear public health career guidance is generally lacking everywhere.
It however should be the priority of universities delivering MPH degrees to teach their graduates what their next steps should be!
Public health graduates in a sense have almost no job prospects, and all job prospects at the same time.
There are clear job roles that qualify new graduates, however, these aren’t very abundant.
Usually, the most successful public health graduates find work either through experience, delivering solid interviews, or demonstrating a passion, general aptitude, and great potential towards a certain aspect of public health.
Because of this, getting a job straight after graduating with a public health degree is very possible.
Overly research oriented
Most public health degrees have four main teachable aspects. Statistics, epidemiology, global health, and research methods.
Unfortunately, regardless of your own personal strengths and interests, you must study all these core modules.
Research methods seem to be particularly problematic since research topics appear in almost all other modules!
When learning about statistics, you may discuss common research measurements, inter- or intra- rater reliability and variability, descriptive statistics etc.
In epidemiology, you will learn about observational study designs in detail, their strengths and weaknesses and how to conduct them!
The thing most students seem to struggle with is when they must write protocols for research methods.
In my personal experience, Protocols for research had to be written on 4 different occasions to get the necessary module points.
This seemed excessive especially considering research isn’t the strong suit of most public health students, especially when some were only learning about certain research methods for the first time.
In this regard, public health degrees should be more balanced and accommodating of people’s strengths!
Poor choice of modules
While public health is known to be multifaceted and diverse in its subject matters, this diversity might not translate over to the course content provided by some universities.
It is true that all institutions are different, however, most actually struggle to provide students with all that public health has to offer since there are only a limited number of credits you can acquire.
The core modules and end-of-year dissertation will usually take up a third of your total course credits, leaving the final third for elective modules.
In most UK institutions, this will roughly be 60 credits dedicated to what you may personally decide to study.
This may sound like a lot, however, many public health modules have pre-requisite modules.
This means you are unable to study one without studying the other before. This might either limit your options greatly or eat into your available credits.
Public health courses actually have a greater selection of modules, however, the downside is you can’t do everything due to time constraints and credit restrictions.
You should however always contact your department leader to ask if you can still do certain combinations of modules, even if the rules are against it.
Public health is an incredibly rewarding field that aims to keep everyone strong, healthy and alert.
As such, public health degrees utilise a vast array of disciplines and techniques to teach future public health experts about the fundamentals of their field.
The degree can either be an MPH or MSc, with not much difference between the two and will position graduates for work within the research and civil service sector.
There is nothing intrinsically wrong with studying public health, however, the huge topic base, combined with often overwhelming yet lacklustre teaching efforts make it a somewhat difficult course to study!
Nothing in academia is ever easy and straightforward.
However, so long as you are aware of the hardships you might face, public health may be an ideal course to serve your interests and deliver gainful employment in the future!
Let us know your thoughts in the comments section below.