Health care decisions are not always rational.
The prevailing model is that medical professionals provide information to patients, and patients follow their advice, points out Collins Ilihenbwa, a global public health scientist with more than 30 years of experience in the field of public health. But look back to the peak of the coronavirus pandemic, when people were being pushed against vaccinations by influential people (some of whom claimed to be doctors themselves) who sowed doubts and skepticism about science.
“Context matters. How people make decisions and what is important to them has to be part of how we understand global health,” he said.
“The global includes the local,” Irihembwa told students at the Aug. 22 opening of Harpur College's new degree program in Global Public Health. Irihembwa, the event's keynote speaker, is a professor of health management and policy at Georgia State University, where he leads the interdisciplinary initiative for global studies of noncommunicable diseases in the university's School of Public Health. He has also authored more than 130 articles, book chapters and six books, including Health and Culture, Beyond the Western Paradigm and Healing Difference, the Global Health Crisis and the Politics of Identity.
More than 80 students have committed to majoring in international public health since the program began last academic year, including several who graduated last May, including Yasmin Gilani, who traveled to Ghana to study and is now enrolled in a master's program in international health policy at George Washington University, according to Binghamton University President Harvey Stenger.
Students listen to speakers during the commencement ceremony for the Global Public Health degree program at Old Union Hall on August 22, 2024. Image by Jonathan Cohen. Students listen to speakers during the commencement ceremony for the Global Public Health degree program at Old Union Hall on August 22, 2024. Image by Jonathan Cohen.
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“We had several freshmen say they chose Binghamton because of this program, and we expect this trend to grow in the future because Binghamton tends to attract bright, talented students who are not afraid of challenges and are eager to make a difference in the world,” Stenger said.
The major has three track degrees: a Bachelor of Science, a Bachelor of Arts, and a Bachelor of Science with a concentration in future health professionals. The degree is flexible and globally focused, allowing students to participate in internships or conduct research outside the United States.
While scientific and medical approaches to health care and assistance are important, researchers and health care workers need a broader base of knowledge and understanding to address barriers to health care around the world. This includes governments, nongovernmental organizations, and cultural, religious and political barriers to health care, Stenger said.
To that end, GPH provides graduates with experience in five core areas: epidemiology, biostatistics, health systems and policy, environmental health, and social behavioral theory.
“This is a unique major,” says Titilayo Okolor, founding director of the GPH program and chair and associate professor of African Studies. “Global Public Health offers public health skills and core courses within a social justice framework.”
“Get used to being uncomfortable”
As a discipline, global public health depends on context, narratives and positionality, says Irihembwa: ultimately, humanity must be at the centre of any attempt to engage and understand different cultures.
“I often quote a Native American saying that the longest journey in life is the journey between the head and the heart,” says Irihenbwa. “The global public health journey is actually a journey into ourselves, of stepping outside of what is familiar to the point where we can understand others from a positive and unique perspective.”
To provide context, Eahihenbuwa asked how many Binghamton students were from upstate New York. Several hands went up. What about the South? New York City? Somewhere in between? What geographic space are people referring to when they say “New York?” Context — knowing exactly where someone is from — shapes the conversation and makes you aware of potential differences, he said.
Keynote speaker Collins Eahihenbwa, a global public health scholar with over 30 years of experience in the field, spoke about the concepts behind the field at the kickoff of the Global Public Health Programme at Old Union on August 22, 2024. Image by Jonathan Cohen. Keynote speaker Collins Eahihenbwa, a global public health scholar with over 30 years of experience in the field, spoke about the concepts behind the field at the kickoff of the Global Public Health Programme at Old Union on August 22, 2024. Image by Jonathan Cohen.
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To explain the concept of positionality, Ilihenbwa posed another question: “Who are you outside of what you do?”
His answer: He's a father, a husband, an uncle, a brother, a teacher, and above all, a student. He's Nigerian and American, a tricky one to make, given that in both contexts he's often told, “I'm not really from here.” People can and do have multiple places and identities, he says.
He reminded students that while health care workers see patients in their vulnerable state, that doesn't represent the whole picture of the patient.
“When we engage, whether it's in this country or another country, we engage with people on a fundamental level,” he said.
Anti-racism and decolonization are important parts of global public health, but that doesn’t mean these principles are limited to far-flung places. Those working in this field should also be concerned with the health of their own local communities, whether in New York or the United States.
“Get comfortable with being uncomfortable,” he advised. “You have to embrace the self-reflection that makes you question your own position. That's part of healthy learning.”
The skills and knowledge students gain in global public health can be applied in many contexts, including the ones they return to and attend school in. After all, Binghamton sits in one of the poorest metropolitan areas in New York State, notes Chancellor Donald Hall. He knows all too well how social conditions affect health issues: He grew up in rural Alabama, where people lacked access to housing and clean water.
“The connection between what we're seeing here and what other parts of the world are experiencing is the concept of 'global,' and that's why we have to be so passionate about global public health issues, because it's our health as well as the health of the world,” Hall said.
