A Vison for the Role of Community Colleges in the Profession of Public Health

Describing Public Health and Community Colleges

Public health is a public good, meaning that everyone in a community benefits from services provided (e.g., water inspections, smoking bans, immunizations), even those that do not pay. Every community in America is serviced through a system of governmental public health agencies represented by roughly 2,800 local, 50 state, and 1 in the District of Columbia (Salinsky, 2010). The public health mission is to assure conditions for a healthy population. It engages with communities by assessing health needs and delivering population-based interventions to improve the public’s health.

Similarly, community colleges in the United States are the community-based component of the nation’s higher education system. Community colleges meet the educational needs of employers and residents in local areas. The community college system is represented by roughly 1,100 institutions across the country that educate approximately 40% of undergraduates (American Association of Community Colleges, 2015; The White House, Office of the Press Secretary, 2015). Community colleges are often the gateway to higher education because of their open-access policies (limited academic restrictions) and lower tuition costs (American Association of Community Colleges, 2015). Such policies foster goals for increasing the educational level of the U.S. population. This, in turn, serves as a catalyst for building vibrant community conditions through an educated workforce so critical to stimulating local economic development.

National Goals

Goals for U.S. community colleges set by President Obama are very ambitious. In 2010, the administration called on community colleges to graduate an additional 5 million students by 2020 (The White House, Office of the Press Secretary, 2015). It is anticipated that the U.S. is likely to face a shortage of approximately 5 million postsecondary educated workers within the current decade. Community colleges currently enroll approximately 7.7 million credit-earning students with approximately 50% representing minority populations (American Association of Community Colleges, 2010, 2015). In his 2015 State of the Union address, the President unveiled the America’s College Promise proposal designed to make 2 years of community college education free for students meeting program requirements (The White House, Office of the Press Secretary, 2015). Such educational goals provide a pathway for improving workforce skills needed to realize equally ambitious goals for dramatic improvements in the health of the U.S. population as set in the 2010 Affordable Care Act (ACA; 2010). Given the relationship of education level to income and subsequent association with increased individual health status, increasing the number of community college graduates aids with achieving population health improvements goals of the ACA as well (Honoré, Graham, Garcia, & Morris, 2008).

Public Health Workforce Strengthening

Reports over many years documented the need to strengthen the public health workforce in the United States (Centers for Disease Control and Prevention, 2013; Gebbie, Rosenstock, & Hernandez, 2003; Honoré, 2015). Inadequate training, limited career pathways, and an insufficient supply of workers are themes consistently noted. Additionally, the workforce is aging. In 35% of states, between 30% and 50% of their public health workforce will be eligible to retire in 2016 (Association of State and Territorial Health Officials, 2014).

As others are acknowledging, community colleges can play a role in filling these public health workforce gaps (Fulcher, Honoré, Kirkwood, & Riegelman, 2010). The U.S. Department of Health and Human Services report, Priority Areas for Improvement of Quality in Public Health, proclaimed community colleges as an “underappreciated partner” (Honoré & Scott, 2010, p. 59) that is perfectly positioned to address the workforce crisis. The report identified workforce and education as one of six priority areas that needed to eliminate quality deficiencies in order to improve system performance.

The most comprehensive assessment on the role that community colleges can play in improving public health education and training was through the Association of Schools and Programs of Public Health’s (2014) Framing the Future: The Second 100 Years of Public Health Task Force. In collaboration with the League for Innovation in the Community College, foundational and consensus statements were developed that articulate the roles that community colleges currently play in the profession of public health and roles that they are postured well to accomplish in the future (Riegelman, Wilson, Dreyzehm, & Huffard, 2014). Examples range from attracting more minority students to public health professions to fulfilling the immediate health workforce needs of employers due to new practice models.

Vision

The discussion in this article attempts to make the case why a vision for intensifying the role of community colleges in public health is essential. Concrete federal examples are provided to demonstrate this importance. Goals in ACA for dramatic improvements in the health of the U.S. population cannot be accomplished without an adequately skilled health workforce. Community colleges represent a large component of the nation’s higher education system. And these colleges already have long-standing relationships with health care professions such as nursing, allied health, and dentistry. Accordingly, goals for building a workforce to support a prosperous and healthy nation should include strategies for expanding public health education in community colleges.

Demonstrating the federal reliance on community colleges to achieving national goals can be seen through examples of Department of Health and Human Services funding. The examples show how programs are implemented to enhance system infrastructures needed to support achievement of population health improvements. The illustrations are certainly not an exhaustive list but clearly demonstrate the importance placed on community colleges to advancing health improvements in communities across the nation.

Funded with $68 million in grants through the 2009 American Reinvestment and Recovery Act, the Office of the National Coordinator for Health Information Health Information Technology implemented the Community College Consortia Program to Educate Health IT Professionals (NORC at the University of Chicago, 2014). Under the program, roughly 20,000 students in 81 community colleges were trained in health IT to address workforce needs across the entire health industry, including public health (NORC at the University of Chicago, 2014).

The Behavioral Health Workforce Education and Training for Paraprofessional grant program administered by Health Resources Services Administration represents another illustration. As a component of President Obama’s Now Is the Time initiative, the program seeks to expand the behavioral health workforce by providing paraprofessional training at community colleges. The program supports plans for protecting communities, with special focus on the population younger than 26, through a reduction in gun violence (The White House, 2013).

Conclusion

Public health has a long and successful history of monitoring and responding to threats to the health of the population. Improvement in U.S. life expectancy in the U.S. has been directly linked to public health practices (Centers for Disease Control and Prevention, 1999). An appreciation for cross-sectoral collaboration over the past decade has led public health to embrace the nation’s community college system as a promising partner to building an even stronger public health system. Appeals to increase the number of graduates and build capacity for public health education and the additional funding opportunities to support health workforce training are critical steps to demonstrating the value of community colleges. Collectively these steps increase the probability of meeting population health improvement goals of the ACA and highlight the role community colleges can play in support of national goals.