Population Matters

June 2, 2011, 3:04 a.m.

Even without a formal school of public health, numerous avenues for public health related research and study have emerged at Stanford independent of a formal structure. Driven by a growing faculty and student interest, the programs range from formal degrees to pure research centers and even student groups.

“It’s an exciting time for population sciences…at Stanford, because there’s a growing interest I think and a sense that in the future population sciences will grow, particularly as the country grapples with creating a new healthcare system,” said Philip Lavori, professor of biostatistics and director of the Health Research and Policy (HRP) department at the medical school.

Public health as a discipline focuses on the science and practice of improving and safeguarding the health of communities, as opposed to medicine, which focuses on individuals. Formally, it includes five disciplines: biostatistics, epidemiology, environmental health sciences, health services administration and social and behavioral sciences.

Population Matters
(ERIC KOFMAN/The Stanford Daily)

“They’re all here, but they’re scattered,” said Donald Barr, professor of human biology and pediatrics. “The students and faculty are interested in subjects that affect the health of the public.”

Yet Stanford has never made a formal move to create a school of public health.

“A school of public health ordinarily encompasses subject matter not included within a school of medicine, and [Stanford’s] goal is not to develop a school of public health,” said Victor Henderson, chief of the division of epidemiology. “At Stanford, we’re particularly interested in gaining knowledge related to disease risk, treatment and prevention. Public health has an added focus on training professionals who implement knowledge of disease prevention.”

Barr added that at one point there was some interest in such a program, describing serving on a committee years ago about making a program in public health at Stanford.

“It just never coalesced,” he said.

Although Stanford may still not be looking to create a formal program in public health, there has been movement to combine many of the existing public health related entities on campus. Faculty members from the school of medicine have engaged in discussions about the future of “population sciences” at Stanford.

“The question that we have is that, since its quite easy to collaborate at Stanford…what’s the value of us trying to figure out how to come together more intimately?,” Lavori said of forming a larger population sciences initiative.

A focus on population health sciences is new for the Farm, which is traditionally more focused on biomedical research.

“Since the 60’s, Stanford’s medical school has been built around biomedical research,” Barr said. “It’s done very well, but it’s never had public health as a core mission.”

Lavori thinks that may be changing.

“Part of it is a natural turning from things that have reached a great stage of maturity, for example stem cell research. They’ve got a building, wonderful grants, CIRM has been terrific, the cancer center is doing well,” he said. “There’s also now a critical mass of faculty at the school who are interested in population sciences…It’s time for us to think about it’s future here at Stanford.”

The existing parts at Stanford include a number of degree granting programs, research centers and student groups.

The only explicit public health related degrees at Stanford can be earned in the Health Research and Policy (HRP) department within the Stanford medical school. The department offers masters of science degrees in epidemiology, biostatistics and health services research.

Henderson said that the masters programs, especially epidemiology, differ from those in a formal public health school, taking a more clinical focus to research and teaching.

Medical students early in their training can also pursue studies in public health through two of the required scholarly concentrations, similar to majors, offered on top of the traditional medical curriculum. The concentrations in community health and health services and policy research relate most directly to those interested in population and community medicine.

“For a lot of our med students, the reason they go into medicine is because they really want to make a difference for people who are disproportionately suffering,” said Lisa Chamberlain, director of the community health scholarly concentration, adding that students can pursue this interest through their concentration.

In addition to required and elective classes, students have the opportunity to further their study through a research project, often community based, sponsored by the medical scholars program. They can also pursue a master’s in public health across the bay at UC-Berkeley.

At the undergraduate level, many students study public health within existing majors, most commonly through areas of concentration within human biology.

“I think the HumBio department does a good job of encouraging students to pursue public health in their coursework, internships and research,” said Erin Duralde, a Human Biology student advisor and editor in chief of the Stanford Journal of Public Health.

“Many other departments have their hand in public health, too,” she added, listing the departments of civil and environmental engineering as well as economics as examples.

Other graduate studies of public health can be pursued through the MA in public policy with a health concentration, or a masters or Ph.D. in biostatistics through the school of humanities and sciences.

In addition to degree granting programs, Stanford also has a number of research centers involved in public health studies.

For example, Stanford’s Prevention Research Center (SPRC) functions as an interdisciplinary research center focusing on problem based inquiry to address preventing and controlling disease rather than treating it. Their subjects range from tobacco and obesity prevention to successful aging and women’s health.

Taking a more directly policy-oriented perspective, Stanford’s Freeman Spogli Institute supports the Center for Health Policy and Center for Primary Care and Outcomes Research.

Both groups take on students as research assistants and can provide an avenue to study public health.

“I’m working at the Stanford Prevention Research Center under Dr. Abby King, helping out with their Neighborhood Eating and Activity Advocacy Team (NEAAT) project,” Duralde said. “It’s been an incredible hands-on experience.”

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