Student interest in health policy spurs new clubs, concentrations

Huddled in a tucked-away conference room at Boston Medical Center (BMC) last Saturday, twenty undergraduate volunteers discussed how they could impact health care policy.

There were no four-color pens in sight. The group--whose members come from a wide range of concentrations--was not talking about medical school applications.

In yet another example of non-premed students becoming involved in health policy issues, the students--members of project HEALTH--were Planning how to improve housing conditions in low-income areas of Boston.

When Project HEALTH (Helping Empower And Lead Through Health), was founded by an undergraduate three years ago, it had 10 members. Now, it has more than 130 volunteers from Harvard and MIT and students at Emerson and Wheelock Colleges and Brown University are opening their own branches.

Yet Project HEALTH's growth is not an isolated event. Student interest in health-related issues outside of the traditional pre-med track has led to a groundswell of academic and extracurricular interest.

Exploring Policy in Health Care (EPIHC), a student group founded last year to help students explore careers in health policy, has grown from 50 students to more than 400.

Academic interest in health policy has peaked as well, with more courses and students interested in them.

Last, month, the Committee on Special Concentrations approved four sophomores' plans to create special concentrations in health policy.

Rebecca D. Onie '97-'98, who founded Project HEALTH during her second year at Harvard, says she thinks there is a need for more undergraduate courses in health policy.

"I wish there were more classes like that when I was an undergrad," she says. "Health policy has a lot of different meanings for people."

Health Care Changes

Many students, like Sara M. Nayeem '99, say their interest in health policy was sparked by President Clinton's efforts to create a national health care system. Recent threats to the traditional doctor-patient relationship have aroused their concerns even more.

"There's a lot of loss of the patient-doctor relationship," says Nayeem, a biology concentrator taking Economics 1435: "The Economics of Health Care" this semester. "There's a loss of independence and the kind of care patients will receive."

"Medicine has improved, and...what you're able to do as a physician has changed with the economics of health care," she said.

Last year, during a review session for Chem 7, four first-years tossed around the idea of studying medicine outside of the pre-med track. The students--Clay Ackerly '01, Noelle S. Sherber '01, Suise Besu '01 and Jamil K. Shamasdin '01--were all intrigued by health care issues and felt that courses like organic chemistry and physics missed the point.

While all four students were drawn to health care policy, Ackerly's interest was more personal: in high school, he went through several brain surgeries.

"Health care has been my life. I've had experiences in it that are very powerful and almost obligate me to study it more," he says. "That's what feeding the fire."

But after attending a meeting of EPIHC and talking with Professor Allan M. Brandt, who teaches Historical Studies A-34: "Medicine and Society," Ackerly was warned that special concentrations are lonely.

Still, the group of four students persevered. They began working to create a joint application to the Committee on Special Concentrations.

While the students were driven by personal experiences, they were also concerned about the direction the country's health care policies are taking.

"I think this country is in need of people looking [at our system]," Sherber says. "Our health care system is all over the place."

Last May, the Committee rejected the students' proposals, saying they were too similar and too abstract. The students stayed in contact throughout the summer and worked to clarify their plans of study.

Their efforts paid off. On September 25, the Committee approved the first special concentration in health policy.

Although each of the four proposals is slightly different--some focus more on economics, others on government--they all include six semesters of health care tutorials and culminate in a thesis.

In addition to economics and government, the students will take courses in sociology, religion, statistics and history of science. There are many courses they could take--more than 150 professors throughout the University teach classes related to health policy.

"It's different, but that's the whole point of the special concentration--to have an interdisciplinary look at health care," Ackerly says. "There are so many resources here that it would be a shame not to tap into them at the undergraduate level."

Three weeks into the semester, the students say they are pleased with how much they've learned.

"We can already talk about the intricacies of Medicare," Sherber says. "We're jumping in, feet first."

The four sophomores say they're not the only undergraduates who are eager to discuss health care policy. Sherber says she has come across many students who are interested in the special concentration.

After she started talking about her academic plans in a section for Social Analysis 10: "Principles of Economics," she was barraged with question from curious classmates.

One of the questions that has evolved from the growing undergraduate interest in health policy is whether the creation of a College-wide concentration is a possibility. Some undergraduates think it should be.

"Harvard should take the initiative to expose people to [health policy courses]," Nayeem says. "I definitely think that more people do go to medical school should takes these [types] of classes."

In order for a new concentration to be created, the entire Faculty must approve the decision. According to Dean of the Faculty Jeremy R. Knowles, a health policy concentration has not been discussed by the Faculty.

Beyond College

Yet despite the burgeoning interest in health policy among undergraduates, one graduate of University's Ph.D program in health policy says he is concerned that students are becoming too focused.

"I think as a pre-med it is somewhat narrow to be a health policy concentrator," says Audiey C. Kao, research director of the Institute of Ethics of the American Medical Association in Chicago.

Yet while Kao expresses reservations about the narrowness of a health policy concentration, he also says it has much educational value for future physicians.

"[It's] certainly something that should be included in the pre-med track," he says. "There's only a handful of physicians who have a health policy background."

Still, Joan P. Curhan is excited about the fact that four students are concentrating in health policy.

Curhan, the director of the Ph.D. program in health policy at the Kennedy School, knows first-hand that special concentrations can have a tremendous impact on a student's life. Her son, Jared Curhan '93, created a special concentration on negotiation and decision-making and went on to found the program for Young Negotiators, a 10-week curriculum that teaches high school teachers how to foster negotiation skills in the classroom.

"It changed his entire life and it's because of that I want to give back to the College," Joan Curhan says. "That's what a special concentration can do."

The Interfaculty Initiative in Health Policy, which Curhan heads, last year put together a booklet called "A Course Guide for Undergraduates Interested in Health Policy." Curhan says she was surprised by the number of courses available.

The booklet includes courses such as Social Analysis 28: "Culture, Illness, and Healing: A Cross-Cultural Comparison of Medicine in Society," Economics 1435: "Economics of Health Care" and History 1912: "Health, Disease, and Ecology in African History."

"Health policy problems, if they're solved, are solved from interdisciplinary approaches," Curhan says.

As hospitals are increasingly being forced to streamline their operations, she says, they need to hire people who are trained in health policy.

"The jobs are really plentiful," Curhan says. "I think out of all the Ph.D. programs, students [in health policy] potentially have the most job opportunities in academic and non-academic jobs."

And while some people worry that undergraduate will draw to health policy because of its potential to lead to lucrative careers, Ackerly says the field goes deeper than that.

"I think [health policy] is so important now and for the long-term, because we're all dealing with our health." he says.