Vision, Tragedy, and Triumph

Celebrating 20 Years of Public Health Education

October 19, 2016

by Karyn L. Feiden

If ever a fairy tale can come true, the 20-year history of Philadelphia’s first public health school shows how. What is today the Dornsife School of Public Health at Drexel University began as a glimmer in the eyes of a few determined people. They gave shape to their bold vision, only to meet tragedy and thethreat of dissolution – and then to emerge triumphant.

Birthing the School

Five academic medical centers flourished in Pennsylvania’s Delaware Valley in the early 1990s, but the region had no public health school, and only one university-affiliated public health program. “It was almost embarrassing that we didn’t have a school of public health,” said Donald Schwarz, MD, MPH, MBA, Philadelphia’s former health commissioner. “It was clear that there was a lot of talent and an increasing number of people who had interest and background in public health, but there was no larger resource.”

A small group of educators and public health practitioners stepped forward to change that. “It is always a risky business to start a school,” acknowledged Jana Mossey, PhD, MPH, MSN, who helped to midwife the school and is now a professor in its Department of Epidemiology and Biostatistics. “It could explode into nothing except embarrassment. It could be costly.”

But the idea resonated with the Allegheny Health, Education, and Research Foundation (AHERF), an expanding package of health-science schools and teaching hospitals in the Philadelphia area. Many players, many proposals and many steps later, with signoff from the Pennsylvania Department of Education, the School of Public Health at Allegheny University of the Health Sciences came into being. It was inaugurated in August 1996 with 24 full-time Master of Public Health (MPH) candidates.

From its inception, the institution was committed to connecting its students to the city that surrounded them. “We said, ‘Don’t keep them in the classroom.’ They should move back and forth fluidly between the two worlds so they gain knowledge and then go and practice it,” said Augusta “Toti” Villanueva, PhD, another of the school’s founders, and currently an associate professor in the Department of Community Health and Prevention.

"We said, You need to take the telescope and turn it around and look at it through the eyes of the community. If you do that, you will do something worth showcasing.'"
- Toti Villaneuva, PhD, associate professor, Community Health and Prevention

The initial MPH curriculum was built on 60 cases that examined national and local public health, which at the time was a very unconventional approach to learning. Required practicum and capstone experiences – such as teaching young people that dating violence is not acceptable and helping sex workers explore other employment opportunities – put students into the heart of the community they were being trained to serve.

Because the starting class and its faculty were so tiny, everyone bonded in very unique ways, recalled Diane Benckert, who has provided administrative support to every dean over the past two decades. “We knew everyone on a very personal level. Everything happened on one floor, faculty and students were together, and that made it more intimate.” The vision of a community engaged public health school in Philadelphia had become real.

Can the Dream Survive?

In January 1998, after more than a year under an interim dean, Jonathan Mann, MD, MPH, assumed the leadership role. Getting him on board was a remarkable coup for a fledging institution. Mann had formidable energy and an international reputation as founding director of the World Health Organization’s Global Programme for AIDS and director of the Bagnoud Center for Health and Human Rights at the Harvard School of Public Health.

In promoting the principles of social justice and health as a human right, Mann’s approach was fully in harmony with the school’s foundational beliefs. “Faculty and staff were taken by the strength of his commitment,” said Mossey. “Jonathan put words to some of the things we had thought about, but perhaps had not articulated very well.” His inevitably creased suit jacket and inexplicably pink socks somehow made him all the more beloved.

Mann had big ambitions for the next generation of public health workers, and pushed faculty to seek transformative changes, not modest service improvements. He cared much less about such tactics as distributing condoms to prevent HIV, and much more about confronting structures that made people vulnerable. He was determined to “put in place strategies that would allow people to thrive and have all the health and well-being they could conceivably achieve,” explained Villanueva.

But tragically, Mann had barely begun to move on his agenda when he and his wife boarded Swissair Flight 111 in September 1998, headed to Geneva for a United Nations conference on AIDS. When the plane crashed five miles off the coast of Nova Scotia, all 229 people on board were killed.

“For a few weeks we thought we wouldn't have a school anymore.”
- Matt Young, MD, MPH '99

That terrible accident compounded the grave threats to the school that had come to light two months earlier, when the parent institution AHERF collapsed into bankruptcy. When Tenet Healthcare Corporation acquired AHERF’s assets, and sought to shed some of its obligations, the brand-new public health school seemed like an obvious target. Student enrollment dropped, faculty departed.

But the formidable Constance Clayton, superintendent of schools in Philadelphia and another “birth mother” of the public health school, was among those who refused to hear of it. “This is too important to close,” she declared, and Tenet took it off the kill list.

It soon came under the umbrella of the newly created MCP Hahnemann University, which Drexel University agreed to operate. Although there were still a few uncertain years to traverse, enrollment slowly headed back up and in 2002, the school was officially merged into Drexel. It had 45 students and five faculty members, degree program.

Powerful Leadership, Remarkable Growth

From her perch at nearby MCP Hahnemann Medical School, where she headed the Division of HIV/ AIDS Medicine, Marla Gold, MD, saw in the public health school a commitment to social justice that matched her own. She agreed to serve as interim dean, and in July 2002, moved into her office, cranked up her favorite music and begin to unpack. Shortly afterwards, a faculty member appeared in her doorway and said, “I need to know right now whether you always play music.” “Yes, as a matter of fact, I do,” replied Gold. “Well, then, could you turn it up so we can all hear it? ” Gold wired the sound into loudspeakers, and declared, “Let’s go.”

In that crescendo, the small but mighty team that had helped to right the flailing school heard a leader who would go on to expand and diversify the faculty, increase student enrollment, attract research grants and put the school on the map. “I made it my business to be at every meeting, large and small, on the national stage with the other school deans,” said Gold. “No matter that I came from a small school, post-bankruptcy, and was with deans from Harvard and Hopkins. I held up my head and talked about the connection to health and human rights. Not many others were doing that. I basically took a seat at the table.”

“We attract the kind of students who want to get out quickly and do great things in the community. At this school, you don't wait to become something, you are something the minute you enter the door.”
- Marla Gold, MD, Professor and Dean Emerita

A year after her arrival, following a national search, Gold was given a permanent appointment. Constantine Papadakis, then president of Drexel University, promised to be generous with resources, and he was true to his word. Gold dusted off plans to pursue accreditation, which had been on hold since the bankruptcy, and started a curriculum overhaul. With faculty approval, centers were spun into departments, and some elements of problem-based learning gave way to more traditional pedagogy. The comic sans font used in some school materials was banned. “Were we becoming more of an establishment school?” asked Gold. “No. We were being creative, holding on to our fundamental values, but meeting standardized criteria so students would come in knowing how excellent their education would be. At the same time, the commitment to community remained at our core.”

Snowballing growth continued. Entering students, who had once gathered in a small room for a Pinning Ceremony marking their initiation into the field of public health, now filed by the hundreds into an auditorium to hear nationally known speakers. In 2007, the Council on Education for Public Health (CEPH) granted the school full accreditation. By 2012, a decade after its merger with Drexel, revenues had increased 700 percent, and total grant funding was up more than 1,100 percent.

Gold stepped down in July 2013, ready to make room for a new leader and another set of big ideas. Ana V. Diez Roux, MD, PhD, MPH, took the helm in February 2014. An internationally known scholar, Diez Roux has published widely on the social determinants of population health and the influence of neighborhoods on health. She previously served on the faculties of Columbia University and the University of Michigan.

“I was impressed when I came by several things that were prominent in the school's history - the links between social justice and population health, the urban health focus, and the strong connection to public health practice and policy ”
- Ana Diez Roux, MD, PhD, MPH, Dean

Diez Roux’s appointment coincided with the school’s move into the seven-story, 78,000-square-foot Nesbitt Hall, following a $13 million renovation. It was a welcome escape from the decrepit Bellet Building, which was notorious for flooding and an elevator that stopped on floors of its own choosing. The new home provided the platform to take the school to yet another level. “Right now, public health research is largely disconnected from practice,” said Diez Roux. “My aspiration is that thisbe the school that generates the most rigorous evidence possible about what drives healthand health inequality and translates that into action.”

With the announcement in September 2015 of the extraordinary $45 million naming gift from Dana and David Dornsife (see accompanying article), all of that and much more seems possible. “The gift allows us to do a number of things that build on the vision we have been working on, and it connects to the history of the school in a very natural way,” said Diez Roux.