Navigating the Evolving Landscape of Public Health Education Standards

The Core Competencies of Public Health Education

In 2019, amidst growing discussions about climate change's role in public health, the Council on Education for Public Health (CEPH), the primary accrediting body for public health schools, emphasized that its curriculum standards already encompassed these critical issues. A key competency from that period required students to delve into how systemic biases, social disparities, and racial discrimination undermine health and present obstacles to achieving health equity at various levels: organizational, community, and societal.

Revisiting Educational Requirements: The Current Conundrum

Today, current events are once again influencing CEPH's competencies, which define the essential educational requirements for public health programs. However, the organization is now considering eliminating language that specifically mandates teaching about "structural bias, social inequities, and racism." This potential shift, not yet finalized, has drawn criticism from some public health educators who view it as a preemptive response to political pressure, particularly from administrations that have targeted and defunded diversity, equity, and inclusion (DEI) initiatives.

The Battle Over Explicit Language in Curriculum

Michael Siegel, a public health professor at Tufts University, voiced strong opposition, arguing that an organization cannot simultaneously advocate for racial justice and against racial inequities—which it has declared a public health crisis—while removing the requirement for students to learn about these very issues. While the Trump administration has not directly targeted CEPH in the same way it has other accrediting bodies, several professors suggest that public health schools in more conservative states may face pressure from state legislatures to avoid certain terminology or topics.

CEPH's Stance and the Accreditation Process

Laura Rasar King, CEPH's executive director, refrained from commenting on the specific competencies under development, stating that the language would be finalized in 2027. Regarding political influence, she affirmed CEPH's goal to uphold rigorous standards while ensuring their criteria are practical for accredited institutions operating within diverse legal and policy environments. CEPH plays a crucial role in shaping public health curricula, accrediting numerous schools and programs, which must demonstrate adherence to these competencies when renewing their accreditation.

Divergent Views on Proposed Revisions

Lauren Junge-Maughan, president of the National Association for Doctors of Public Health, echoed concerns about the proposed changes, highlighting the profound importance of CEPH's competencies as the foundational framework for all accredited public health programs. The current 2024 language explicitly requires educators to discuss how structural bias, social inequities, and racism impede health equity. However, a proposed revision in 2025, after the second Trump presidency, rephrased this to focus on analyzing "factors that create disparate health outcomes," later refined to "examine systemic factors that contribute to challenges in achieving optimal population health."

Seeking a Middle Ground or Backsliding on Progress?

Marc Kiviniemi, a public health professor at the University of Kentucky, views the latest language as a reasonable compromise. He believes it still enables students to understand and analyze how structural and social issues, including prejudice and discrimination, influence health outcomes. Conversely, others fear that removing explicit mentions of racism constitutes a regression from the concerted efforts during the COVID-19 pandemic, which underscored racism as a significant determinant of health disparities. During the second Trump administration, initiatives addressing structural racism faced considerable opposition, with the administration challenging DEI-based standards in academic accreditation and even attempting to reclassify public health degrees.

Navigating Political Pressures and Educational Autonomy

In July, CEPH voluntarily withdrew its recognition from the Education Department, citing increasing political interference in the recognition process. Several professors believe that schools in politically conservative states are concerned that explicit language about racism could become a liability, and that revised language might offer a more palatable approach. Amy Fairchild, a historian at the University of Minnesota, suggests that broader language could be more inclusive, allowing for discussions on class and rural health disparities, and facilitating dialogue with those who hold differing views.

The Future of Public Health Education

However, Harry Heiman, a professor at Georgia State University, argues that altering standards will not necessarily benefit programs in conservative states, as explicit competencies provide a protective shield against scrutiny. He and others emphasize that CEPH's competencies represent a minimum standard, and schools retain the autonomy to teach beyond these guidelines. India Ornelas, a health systems professor at the University of Washington, points out that despite potential watering down, many schools will continue to teach about health equity and the impact of racism. The outcome of CEPH's decisions could mark a pivotal moment for the public health field, prompting a deeper reevaluation of how it addresses systemic biases. Ornelas and her colleagues have established the Health and Power Organizing Project to empower academics and advocates to counteract political pressures.