Nov. 01 2019

How Do You Imagine the Future of Public Health?

Since its founding nearly 100 years ago, the Columbia Mailman School has helped carry out a vision of the future where people live longer, healthier lives. This fall, the School is launching Public Health 2035, a strategic visioning process that will chart a course for the School as it starts its second century.

On a recent morning in Bard Hall, a group of 65 faculty gathered to share their perspectives on the trends that could transform the field and the School over the next 15 years. The workshop was led by the Institute for the Future, a non-profit think tank based in Silicon Valley that provides educational institutions, NGOs, foundations, governments, and corporations with research-driven “foresight” to enable them to leverage future forces to prepare for greater organizational success and impact.

Bob Johansen, a distinguished fellow with IFTF, told faculty that humility is a necessary trait for futurists since nobody can really predict the future in specific terms. To be ready for the years ahead, organizations must be radically flexible (“shape-shifting,” in Johansen’s words) and find clarity by eschewing certainty. He said he looked forward to collaborating with faculty and explained that the process, which builds from a foundation of faculty input, was designed to “provoke your insight based on our foresight.”

Seated around tables with colleagues from a mix of academic departments, public health scholars and scientists from diverse specialties worked through a series of exercises to identify the developing trends that impact public health, as well as the potential future disruptors that may affect the field and our work (“signals,” in IFTF parlance) —all while considering the potential implications of both.

Ideas emerged rapid-fire, jotted on yellow stickie notes and refined through lively back-and-forth: environmental degradation, ballooning inequality, urbanization, population aging, biohacking, gender fluidity, and more. At the conclusion of each brainstorming session, representatives from each table shared their insights, flagging the potential risks and rewards.

A demographic shift toward a minority-majority population in the United States might lead to a major reallocation of resources, offered Robert Fullilove, professor of sociomedical sciences. Advances in health technology could improve individual diagnoses while also exacerbating disparities, added Regina Santella, professor of environmental health sciences.

In her table’s 2035 vision, Rachel Shelton, assistant professor of sociomedical sciences, the field of public health would be democratized with more robust collaboration between researchers and communities, a move that could open up new avenues for funding. Presenting another optimistic take, Julie Kornfeld, vice dean of education, said a more complete provision of services would remove material inequity and diminish health disparities.

These insights and others, along with a big pile of stickie notes collected by IFTF, will provide the initial inputs for the Public Health 2035 project, which also draws on outside expertise and literature reviews. Ongoing opportunities will be available for faculty to share their expertise and insights, including through discussions at department and center meetings, School Assembly, and through online forums. A 25-member faculty steering committee is overseeing the initiative, whose initial phase will continue through the spring.

Faculty had good things to say about the exercise.

“The kick-off meeting was thought-provoking and emphasized an inclusive, group approach which I really appreciated,” remarked Susan Michaels-Strasser, assistant professor of epidemiology and senior implementation director and associate director for nursing programs at ICAP. “Many ideas were put on the table—from the urgency of climate change, current threats to the concept of public goods (and by association to public health), to the use of new technologies and big data to change health services and systems.”

“Overall, I found the workshop very valuable,” said S. Patrick Kachur, professor of population and family health. “Leading from a position of clarity, rather than certainty, resonated particularly well with some of my experiences over my career. And I easily saw the value for visioning future priorities and positioning for them. But I also recognized in it, a tool that I can put into practice immediately in many of my projects and collaborations.”

At the conclusion of the first phase of Public Health 2035, the IFTF team will deliver a custom forecast that identifies the key shifts likely to inform the future of public health, learning, and academic research, as well as potentially disruptive forces to them. Based on this plan, the School will then create a vision for the future to maximize its public health leadership and impact while preserving financial stability, along with an action plan to achieve that vision.

Just as a previous strategic planning process in 2008 led to major changes such as the creation of the Core Curriculum, Public Health 2035 is expected to usher the School into new areas of research capability, new methodologies and audiences for teaching, and new ways of deploying research to improve public health.

Reflecting on the 1922 founding of the DeLamar Institute which grew into the Columbia Mailman School, Dean Linda P. Fried said the field of public health was from its beginning about creating a better future by providing the research and learning to elevate health on the population level. “Ninety-eight years later, we still do the same thing,” she said. “Now is the time to ask ourselves: Are there new ways in what we do each day to build a better future?”