Emerging Trends in Professional Preparation: Implications for the Future of Health Education

R. Morgan Pigg, Jr.

ABSTRACT

During the 1982-1983 academic year, 115 academic institutions were surveyed concerning trends in professional preparation in Health Education. Findings indicate that 13,225 students are currently majoring in Health Education with 4,810 specializing in school health education and 8,415 specializing in public health education. A marked increase in the number of students specializing in public health education within the past five years was reported by 78 institutions and 13 of the 78 institutions reported a corresponding decrease in the number of students specializing in school health education. Recent enrollment trends at teacher preparation institutions suggest that significant changes in professional preparation in Health Education are under way.

INTRODUCTION According to data contained in a recent report from the

Bureau of Health Professions concerning the status of public health personnel, I an estimated 25,000 individuals are currently employed as health educators. Of that number, about 20,000 are employed in school health education while approximately 5,000 are employed in public health education. Traditionally, school health education - by far the larger specialty - has been the province of professional preparation programs located within teacher preparation institutions. Likewise, preparation in public health education has occurred primarily within the Schools of Public Health.

Recently, it has been suggested that this traditional relationship may be changing. To determine if changes are in fact occurring, and to determine if discernable trends or patterns of change are evident, a national study of professional preparation programs in Health Education was undertaken.

METHOD During the 1982-83 academic year, 293 institutions offering

professional preparation programs in Health Education were identified.2.3 From that number, 115 institutions offering degree programs in both school health education and public health education were identified. The study was delimited to the 1 1 5 institutions offering degree programs in both areas of specialization to facilitate a direct comparison of enrollment data and the identification of trends between the two areas of specialization at the respective institutions.The status of pro- fessional preparation at the 178 institutions offering degree programs in only one area of specialization was beyond the scope of this study. Each of the 115 institutions was contacted and requested to complete a survey instrument concerning current enrollment data and trends within the two areas of specialization. Of the 115 institutions contacted, 107 (93.04%) participated in the study.

FI NDl NGS Enrollment

At the undergraduate and graduate levels, gross enrollment data from the 107 institutions indicate that 13,255 students are specializing in Health Education (x = 123.60 per institution). A total of 8,963 students were reported at the undergraduate level (x = 83.77 per institution), while 4,262 students were reported at the graduate level (X = 39.83 per institution).

The 107 institutions reported 4,8 10 students currently specializing in school health education at the undergraduate and graduate levels (X = 44.95 per institution). Total reported undergraduate enrollment at 99 institutions was 3,564 students (x = 36.00 per institution) while total reported graduate enrollment at 76 institutions was 1,246 students (7( = 16.39 per institution).

Likewise, the 107 institutions reported 8,415 students specializing in public health education at the undergraduate and graduate levels (x = 78.64 per institution). Total reported undergraduate enrollment at 94 institutions was 5,399 students (R = 57.44 per institution) while total reported graduate enrollment at 67 institutions was 3,016 students (X = 45.01 per institution).

Trends The 107 institutions were requested to provide information

concerning trends in the selection of an area of professional specialization by major students at the institutions within the past five years. Some 78 institutions (72.90%) reported a marked increase in the number of students choosing to specialize in public health education, and 13 of the 78 reported a corresponding decrease in the number of students selecting school health education. Increased enrollment in school health education was reported by two institutions (1.87%), increased enrollments in both school health education and public health education were reported by six institutions (5.61 Vo), and decreased enrollments in both school health education and public health education were reported by two institutions (1.87%). No noticeable changes or trends were reported by 16 institutions (14.95%) and three institutions (2.80%) did not respond.

DISCUSSION The findings of the national study confirmed a discernable

increase in the number of public health education specialists - and a corresponding decrease in the number of school health education specialists - being prepared by the 107 reporting institutions. Three fundamental questions raised by these find- ings are worthy of consideration: 1) What are the implications of this trend for the future of school health education?; 2) What are the implications of this trend foy the future of public health education?; and 3) What impact will this trend have on the traditional relationship between schools of public health and other academic institutions?

Though school health educators reportedly constitute an estimated 80% of the total number of professional health educators in practice,' student majors at the 107 institutions clearly indicated a growing preference for public health educa- tion as an area of specialization. Some of the 107 study respondents reported that no students are enrolled in their school health education degree programs and some reported that their programs have been entirely deactivated. If the trend continues, it may become increasingly difficult to identify individuals to be prepared to meet the critical need for competent school health educators.

Likewise, the traditional relationship between schools of public health and teacher preparation institutions is apparently undergoing a marked change. The 107 institutions (nonschools of public health) reported a total of 8,415 students specializing

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in public health education - a number far in excess of the estimated 5,000 public health educators currently in practice. Theoretically, if the 8,415 students graduate, the number of public health educators could virtually triple by as early as 1985. In a period of economic recession, it is unlikely that future job markets will absorb such an increase in the number of public health educators being prepared, particularly at the undergraduate level.

As enrollments in public health education programs at teacher preparation institutions have increased, a number of poignant issues have emerged concerning the treatment of these programs and their graduates in relation to policies and practices applied to schools of public health. A recent study-”J by the Bureau of Social Science Research raised a number of questions concerning ‘ I . . . the fairness of some of the funding and employment practices which favor public health school programs and graduates . . .” and the findings of the report are predicted to have “. . . serious consequences for various aspects of graduate education in public health.”6 This matter may well emerge as the critical issue in professional prepara- tion in Health Education during the remainder of this century. If challenges to the existing policies and practices are successful, the implications for the profession of Health Education - both school health education and public health education - will be profound.

CONCLUSIONS Since the study was delimited in scope to 115 institutions

offering degree programs in both school health education and public health education, any conclusions drawn from the study must be interpreted accordingly. However, the study high- lights the complex and disconcerting realities that surround the present status of professional preparation in Health Educa- tion. Clearly, current emphases in Health Education are shifting toward nonschool specialties such as patient educa- tion, employee health education and public health education. Candidly, the immediate future of school health education is unsettling but there is cause for guarded optimism.

If predictions of a general teacher shortage in the late 1980s prove correct, the demand for school health educators should increase, particularly if they are certified to teach one or more additional academic subjects. Likewise, the recent national movement toward the control of chronic diseases through health promotion and disease prevention programs gives specific attention to child health,’ and it seems logical to assume that the promotion of child health will continue to be a goal of the American people. In the interim, school health edu- cators must 1 ) resist the understandable impulse t o deactivate professional preparation programs in school health education because the viability of such programs should improve. within the next five years and 2) continue to serve as strong advocates of child health both within and outside the profession since the need for such advocacy is acute.

Perhaps the greatest challenge ultimately confronting school health educators and public health educators alike is the maintenance of credibility as a profession. Lasting credibility may only be achieved by ensuring the quality of professional preparation programs and the competence of program gradu- ates. Current program accreditation measures, which are inadequate at best, may well collapse beneath the proliferation of programs and the sheer volume of graduates from these programs; and recent attempts to create an objective system of credentialing for professional health educators have been beset by a seemingly endless series of obstacles. However, the effort to establish clear, fair and universally applicable standards for professional quality and competence in Health Education are commendable and should be continued, since such efforts offer the best hope for the continued progress of the profession.*-’ I

References

1. Public Health Personnel in the United States, 1980. Bureau of Health Professions, USDHHS, 1982.

2. AAHE directory of institutions offering specialization in undergraduate and graduate professional preparation programs in health education. Health Educ 13:31-39, 1982.

3 . A National Directory of College and University Health Educa- tion Programs and Faculties. Muncie, IN: Eta Sigma Gamma, National Health Science Honorary, 1981.

4. Holmstrom El: Characteristics of U.S. Graduate Education in Public Health Outside Schools of Public Health. Washington, DC, Bureau of Social Science Research, 1982.

5 . Holmstrom EI: Overview of Graduate Programs in Public Health Outside Schools of Public Health, 1981-82. Washington, DC, Bureau of Social Science Research, 1982.

6 . Holmstrom EI: Bureau of Social Science Research, Washington, DC, letter, January 18, 1983.

7. Healthy People: The Surgeon General’s Report on Health Promotion and Disease Prevention. USDHEW, Washington, DC, 1979.

8. Preparation and Practice of Community, Patient, and School Health Educators: Proceedings of the Workshop on Commonalities and Differences. Bureau of Health Manpower, USDHEW, 1978.

9. Initial Role Delineation for Health Education. Bureau of Health Professions, USDHHS, 1980.

10. Schaller WE: National Conference for Institutions Preparing Health Educators: Proceedings. Office of Health Information and Health Promotion, and Physical Fitness and Sports Medicine, USDHHS, 1981.

11. Henderson AC: The Refined and Verified Role for Entry-Level Health Educators. Muncie, IN, Eta Sigma Gamma, National Health Science Honorary, 1982.

R. Morgan Pigg, Jr., HSD, MPH, Graduate Program Co- ordinator, Dept. of Health and Safety Education, Indiana University, Bloomington, IN 47405.

7 Conference on Sexual Victimization of Children I The third National Conference on Sexual Victimization of Children will be held April

26-28, 1984 at the Sheraton National Hotel in Arlington, Virginia. For further information, contact Conference Coordinator, Division of Child Protection,

Children’s Hospital National Medical Center, 11 1 Michigan Ave., NW, Washington, DC, 20010. The basic registration fee for the conference is $1 10.

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