关于美国公共卫生专业

一、公共卫生是什么？

1. 公共卫生的定义

公共卫生是通过组织社区资源，为公众提供疾病预防和促进健康的一门管理学，它使用预防医学、健康促进、环境卫生、社会科学等技术和手段。公共卫生体系由国际公共卫生组织、国家公共卫生组织、地方公共卫生组织和社区公共卫生组织组成。

HSPH的分类:

EnvironmentalHealth

• Biostatistics

• BehavioralScience/Health Eucation

• Epiemiology

• HealthServices Aministration/Management

• Maternal anChil Health

• Nutrition

• International/GlobalHealth

• PublicHealth Laboratory Practice

• Public HealthPolicy

• Public HealthPractice

Overall, public health is concerne with protecting the health of entire populations. These populations can be as small as a local neighborhoo, or as big as an entire country.

公共卫生涉及的学科知识:

• 流行病学 Epiemiology

• 预防医学 Preventive Meicine

• 生物统计 Biostatistics

• 环境卫生 Environmental Health

• 职业卫生 Occupational Health

• 卫生政策 Health Policies

• 医学管理 Meical Management

• 组织与机构

1. 按组织划分

国际公共卫生组织。通过参加组织、加入协约与公约等形式，指导、监督、协调各个国家与地区的公共卫生工作。如世界卫生组织、绿色和平和世界自然基金会等等。

国家或地区（及地方）公共卫生组织。作为政府行政管理机构，代表政府提供公共卫生服务，共同发挥支柱作用。如卫生部门（U.S. Department of Health an Human Services，分支机构如CDC-Center for Disease Control）、劳工与保障部门（U.S. Department of Labor）、国土与环境部门和规划与发展部门等。

1. 按职能与职责划分

卫生保健提供者。如医院、社区健康服务中心、精神卫生组织、实验（检验）中心、护理院，主要提供预防、诊断、康复和护理服务。

公共安全组织。如警察局、消防队、医疗急救中心，预防处理紧急伤害和公共卫生事件。

环境保护、劳动保护和食品安全机构。作为执法部门，监督和保障安全的生存环境、保障人群健康。

文化、教育、体育机构。为社区提供促进健康的精神环境和物质环境。

民政、慈善组织。为弱势人群包括失能人士、低收入人士和独居及高龄人士提供政策与物质支持。

1. 按人群划分

儿童疾病与死亡

孕产妇疾病与死亡

老年人生活质量

1. 按健康问题划分

传染病：SARS、禽流感、流感、疯牛症、艾滋病 登革热

慢性非传染性疾病：肿瘤、糖尿病、高血压

意外伤害：车祸

不良健康行为：吸烟、饮酒 吸毒 不安全的性行为

精神及心理卫生:忧郁症

一、 公共卫生院系设置介绍

在美国, 并不是所有的大学都有公共卫生学院或者相关专业，特别是独立的公共卫生学院，往往在一个州中仅有1到2个大学具备较大的完整的院系设立。而正是这1到2个大学的公共卫生学院承担了与本州卫生部门共同进行的疾病预防﹑健康教育﹑环境卫生等一系列重大事件的规划与执行。一般来说，独立的公共卫生学院有以下分系：卫生统计学(Biostatistics)﹑流行病学(Epiemiology)社区与健康教育学(Community An Health Eucation)﹑卫生政策与管理学(Health Policies An Aministrations)﹑环境与职业病卫生学(Environmental An Occupational Health)。

以Harvar School of Public Health为例，其下设的方向和学位包括有：

Department of Biostatistics

SM (42.5-creit, 60-creit, an 80-creit programs), PhD

Department of Environmental Health

Exposure, epiemiology, an risk: SM (42.5-creit an 80-creit programs, incluing 80-creit program in inustrial hygiene), SD

Molecular an integrative physiological sciences: SD, PhD (through the Division of Biological Sciences)

Occupational health (incluing programs with Simmons College): MOH, SM (42.5-creit an 80-creit programs), SD, DPH

Department of Epiemiology

SM (42.5-creit an 80-creit programs), SD, DPH

Department of Genetics an Complex Diseases

PhD (through the Division of Biological Sciences)

Department of Global Health an Population

SM (80-creit program), SD, DPH

Department of Health Policy an Management

SM (42.5-creit an 80-creit programs), SD

Health care management (part-time, nonresiential): SM (42.5-creit program)

Health policy: PhD (through university program)

Department of Immunology an Infectious Diseases

SD, PhD (through the Division of Biological Sciences)

Department of Nutrition

Nutritional epiemiology, public health nutrition: SD, DPH

PhD (through the Division of Biological Sciences)

Department of Society, Human Development, an Health (incluing joint programs with Simmons College)

SM (42.5-creit an 80-creit programs), SD, DPH

Health communication: SM (80-creit program), SD, DPH

Maternal an chil health: SM (42.5-creit an 80-creit programs), SD, DPH

Master of Public Health Program

Clinical effectiveness, family an community health, health care management an policy, international health, law an public health, occupational an environmental health, quantitative methos: MPH

Combine MD-MPH

Joint JD-MPH (for Harvar law stuents only)

Definition of Terms

DPH Doctor of public health

MOH Master of occupational health

MPH Master of public health

PhD Doctor of philosophy

SD Doctor of science

SM Master of science

二、公共卫生教育

申请的要求：

1. 从HSPH和JHSPH的申请要求上，我们可以发现，这些公共卫生学院对申请的要求，1）至少需要具备本科学历；
2. 就是不同的学院、专业方向和学位，对申请者都有某一个和数个方面的特殊要求
3. 学分越少的Program，对申请人的要求越苛刻。

The Departments of Biostatistics an Epiemiology will review applicants holing a minimum of a bachelor’s egree for the master of science 80 creit or the octoral program (PhD or SD, respectively).

The Departments of Environmental Health; Global Health an Population (formerly Population an International Health);Health Policy an Management; Nutrition; an Society, Human Development, an Health may consier applicants with a minimum of a bachelor’s egree, however, most successful caniates have some relevant work experience.

Degree Name Prerequisite Degree Requirements

Master of Science 80 creit SM Requires prior bachelor’s egree or non-US equivalent. Some epartments prefer work experienceŒ. See epartmental websites for more specific information. The 80-creit master of science is offere in Biostatistics; Environmental Health; Epiemiology; Global Health an Population (formerly Population an International Health); Health Policy an Management; an Society, Human Development, an Health.

Master of Science 60 creit SM Requires prior bachelor’s egree or non-US equivalent in one of the mathematical sciences or an allie fiel (for example, biology, psychology, or economics)?. The 60-creit master of science is offere in Biostatistics.

Master of Science 42.5 creit SM Please see epartmental websites for specific prerequisite egree requirements. For most epartments, applicants must hol a prior octoral egree. The Department of Environmental Health will review applicants with a master’s egree in a relate iscipline or significant professional experience?. The Department of Society, Human Development, an Health will review applicants with a prior relate grauate egree an experience in the public health fiel. The 42.5-creit master of science is also offere in Biostatistics, Epiemiology, an Health Policy an Management.

Master of Public Health

MPH

Requires prior octoral egree- for example MD, DO, DDS (or their non-US equivalents), PhD, SD, JD, or other health-relate octoral egrees. MD an DO stuents may apply to enroll between thir an fourth year in meical school. Also eligible to apply are those with a master’s egree in a health-relate fiel (for example, MSN, MSW, MBA) an three years of relevant experience. The law an public health concentration requires a prior JD or non-US equivalent egree?. Law stuents alreay holing a relevant avance egree may also be consiere. Stuents who may have been accepte to Harvar Law School may apply to a joint JD/MPH program.

Master of Occupational Health MOH Requires prior meical egree. The master of occupational health is offere through the Department of Environmental Health.

Doctor of Science SD Bachelor’s egree or non-US equivalent except for the Departments of Health Policy an Management (requires prior meical egree) an Immunology an Infectious Diseases (requires prior clinical egree). The SD is also offere in Environmental Health; Epiemiology; Global Health an Population (formerly Population an International Health); Nutrition; an Society, Human Development, an Health.

Doctor of Public Health DPH Applicants must have, or be in progress towar, an MPH egree, in aition, caniates must hol an avance egree in a basic public health iscipline similar to the requirements for the master of public health (42.5 creit) program liste above?. The DPH is offere by Environmental Health; Epiemiology; Global Health an Population (formerly Population an International Health); Nutrition; an Society, Human Development, an Health.

Doctor of Philosophy PhD All PhD programs are offere uner the aegis of the Harvar Grauate School of Arts an Sciences‘.

专业的不同侧重：从两个不同专业Degree Planners侧重的能力解读

Epiemiology Environmental Epiemiology

• Demonstrate basic skills in core public health sciences of epiemiology an biostatistics.

• Develop comprehensive knowlege of the role of epiemiology as a basic science for public health an clinical meicine to provie a quantitative approach to aressing public health an clinical problems.

• Interpret escriptive epiemiologic results in orer to evelop hypotheses of possible risk factors for a isease.

• Critically evaluate public health an meical literature through knowlege gaine of the basic principles an methos of epiemiology, incluing isease (outcome) measures, measures of association, stuy esign options, bias, confouning, an effect measure moification.

• Apply quantitative skills to analyze an synthesize epiemiologic ata relate to public health issues.

• Develop quantitative skills neee to analyze an synthesize epiemiologic ata.

• Apply knowlege of the physiology an pathophysiology of human isease to epiemiologic stuies.

• Develop the skills to interpret the methos for isease screening.

• Develop substantive knowlege of the epiemiology of infectious an chronic isease an apply this knowlege to public health issues.

• Design an epiemiologic investigation (Master’s Thesis) resulting in a publishable manuscript or grant application.

• Demonstrate competence with the 5 core isciplines for the professional SM egree program (liste in the MPH Curriculum Guie).

• Characterize contaminant sources an mechanisms of environmental transport.

• Ientify, moel, measure, evaluate an interpret the human contact with environmental contaminants that constitutes exposure, an evelop strategies to control environmental hazars, allergens, an pathogens.

• Investigate health effects by applying appropriate statistical an epiemiological concepts an techniques to the relationships between environmental hazars an health outcomes.

• Employ risk assessment an management strategies to minimize averse outcomes.

• Communicate effectively with iniviuals an communities regaring risk associate with environmental hazars.

1. 卫生统计学(Biostatistics)：

是近几年的大热学科，除开医学学生，不少数学和统计等理科的同学也纷纷申请。这个专业在美国前景非常之好，可以说就业面广，包括医药公司﹑政府卫生部门和高校都需要此专业人才，技术性强，很少能被其他专业人才所取代，毕业后平均年收入也比其他卫生类专业更高。卫生统计学的申请者不一定需要医学背景，但往往学校会要求在本科或研究生阶段有一定的高等数学和统计学课程。

1. 流行病学(Epiemiology)：

和卫生统计学科有很大的交叉，都需要能熟练的运用统计学软件和原理，但对于疾病本身关注相对较多，毕业后大多也在各级别卫生部门从事相关工作，如艾滋病防治，心脏病的防治项目等。申请时更看重申请人的医学背景，被录取者多来自公卫本专业﹑临床﹑药学﹑护理﹑基础医学等专业，对于国际学生更是看中医学相关背景。

1. 社区与健康教育学(Community An Health Eucation)：

是所有公卫专业中最看重英语能力的，所以其GRE和IBT要求也最高，因为毕业后所开展的工作多以社区为基础，强调与人群沟通能力。其工作范围也相对较广，渗透在几乎卫生事业各级别各类型工作中。申请人如果要申请此方向，英语口语能力和过往实际的公共卫生相关工作经验尤为重要。

1. 卫生政策与管理学(Health Policies An Aministrations)：

是公卫专业所有专业里最偏向管理学和政治学的科目，甚至有部分课程来自MBA和法律专业。毕业生多在不同部门扮演卫生政策的制定者或法律援助群体，也有很多在健康保险和其他健康相关产品行业里工作。此专业对申请人的写作能力以及工作或实习经验较为看重，国际学生申请此专业较统计学和流行病学相对较难，因为需要申请人了解美国的政府构架和法律规范。

1. 环境与职业病卫生学(Environmental An Occupational Health):

这是全世界范围内的热门学科，在美国也如此，美国的环境与职业病卫生学贯穿于水质﹑空气﹑土壤﹑基础设施建设和制造产业中的卫生规范与管理，每年政府也会大力投入大量的人力和物力资源。可谓说此专业是很多美国本土学生也致力申请的方向，而申请者也不需要强调医学背景，其竞争激烈，前景光明，对国际学生也并非有太高的语言门槛。

三、学位设置

各个大学的公共卫生学院学位设置大致相同，它们包括，MPH(Master Of Public Health)﹑MSPH(Master Of Science Public Health)﹑PHD﹑MHA(Master Of Healthcare Aministration)。MPH和MSPH的区别在于前者多培养学生的实际工作能力，后者多培养学生的科研能力并可以进一步深造Ph.D学位。 MHA学位强调学生作为管理者的能力，如人力资源管理，市场策划等，是所有专业中最接近MBA的一种。PHD专业是为高校﹑研究机构﹑政府部门培养的科研人才，一般奖学金非常丰富，毕业后留美机会较大。

四、申请人需做的准备

公共卫生是热门学科，竞争非常激烈。GRE和IBT考试肯定是必不可少的，TOP20的公共卫生学院一般要托福100分以上(Speaking 20)。同时学院希望申请有一定的医学相关背景，尤其针对国际学生，如没有医学相关学位，申请者可以积极参与国内的公共卫生项目，如疾病的宣传教育课题，这样可一定程度上弥补背景的不足。在申请过程中，PS(Personal Statement)和CV显得尤为重要，学院希望申请人有对卫生保健事业的强烈兴趣和责任感，这往往从对自己未来的计划和对过去背景的总结介绍中得知。公共卫生的研究生阶段奖学金甚少，因为这也是当前全美国的热门学科，而排名靠前的公共卫院一年的学费和生活费大约在3万5到5万美金左右。PHD阶段奖学金会相对多一些，但是竞争也是比较残酷。

公共卫生作为当前世界重要的议题，无论在中国和美国都具有相当好的发展前景，在最近北美经济走势不佳的情况下，仍然是非常热门和容易找工作的学科。有此志向的同学可以提早为自己的将来做详细的规划，准备好自己的申请。

就业方向：

1. 卫生保健提供者。如医院、社区健康服务中心、精神卫生组织、实验（检验）中心、护理院，主要提供预防、诊断、康复和护理服务。
2. 公共安全组织。如警察局、消防队、医疗急救中心，预防处理紧急伤害和公共卫生事件。
3. 环境保护、劳动保护和食品安全机构。作为执法部门，监督和保障安全的生存环境、保障人群健康。
4. 文化、教育、体育机构。为社区提供促进健康的精神环境和物质环境。
5. 民政、慈善组织、NGO。为弱势人群包括失能人士、低收入人士和独居及高龄人士提供政策与物质支持。
6. 大型企业的员工健康支持，健康保险公司

政府部门：

Agency for Health Care Research an Quality (AHRQ)

Centers for Disease Control an Prevention (CDC)

Foo an Drug Aministration (FDA)

Health Resources an Services Aministration (HRSA)

Maternal an Chil Health Bureau, HRSA (MCHB)

Office of Disease Prevention an Health Promotion (ODPHP/HHS)

Public Health Functions / HP 2010

Substance Abuse an Mental Health Services Aministration (SAMHSA)

U.S. Department of Agriculture (USDA)

US Department of Health & Human Services (HHS)

US Agency for International Development (USAID)

Feeral Government Salary Table for the DC-MD-PA-VA-WV areas