The Public Health of Higher Education

What would a parallel, public-health version of higher education look like? The massive open online courses (MOOCs) increasingly available for free on the Internet offer one aspect of this.
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The health of higher education has received a lot of public discussion of late. The symptoms of the system's ill health have included tuition increases far exceeding the rate of inflation, administrative bloat expanding the waistline of many institutions, declining levels of state support for public universities, and a growing divide between the haves and have-nots in terms of educational access and attainment. Some of my most-complacent colleagues question the severity or seriousness of these symptoms, while others - overly enthusiastic revolutionaries - see in these signs the impending death of higher education as we have known it.

Both extremes seem unwarranted. We need to take the signs of ill health more seriously than the former and less seriously than the latter. What ails higher education has less to do with the symptoms of illness, and more to do with a deeper and more chronic disease: the assumption that education involves the acquisition of a product (a degree) that students (and often their parents) pay for in a finite period of time and that will then last them the rest of their lives. As happens too often in medicine, when patients expect a doctor to patch them up or fix their problem without changing the behavior that led to the illness in the first place, the idea of our going to college, getting a degree, and applying what we have learned in a job overlooks the fact that education is a life-long process and not a product at all.

That may seem like an obvious observation, but it leads to a very different - and a much healthier - future for higher education. Let me give you an example from my own field of design. Design, like higher education, has long followed a medical model of practice. We devise custom solutions to the needs of fee-paying individuals or organizations, much like faculty do with tuition-paying students and like doctors do with insurance-carrying patients. This fee-for-service activity works well for the relatively small percentage of the global population able to pay to play, but it leaves out the vast majority of people around the world with needs as great or greater than those who have the means to participate in this system.

Recognizing its obligation to everyone's health and well-being, medicine long ago gave birth to the field of public health, which attends to the needs of large populations regardless of their ability to pay. The design fields have begun to give birth to an equivalent practice, what we have come call public-interest design, that provides affordable, sustainable, and replicable solutions to the needs of people in particular places, with their engagement and empowerment uppermost in mind. This has led to a growing number of low-cost, culturally and climatically appropriate designs that have transformed the lives of millions of people, with the financial support of everything from large foundations and governmental organizations to small crowd-funded donations from thousands of individuals.

What would a parallel, public-health version of higher education look like? The massive open online courses (MOOCs) increasingly available for free on the Internet offer one aspect of this. Like the vaccines that have eliminated global diseases such as polio and smallpox, and have in turn brought better health to people all over the world, MOOCs can do the same with information and education - assuming those with a device have access to the Internet. But public health involves more than vaccines, and so too does a public-health version of higher education require more than MOOCs. It demands a much finer grained involvement with and engagement of people in the places they inhabit in an on-going process of self-improvement.

MOOCs constitute what some call the "flipping" of courses, in which lectures formerly given in person now reside on the Internet for viewing at home. But a public-health version of higher education needs to go beyond that to the "flipping" of the academy. In such a scenario, students wouldn't just come to campuses in order to learn, but academics would also bring what they offer on campuses into communities. Community colleges, extension services, and continuing education programs all represent versions of this idea, but they still work on the medical model of practice in which students pay tuition or the public pays taxes in order support the enterprise. A public-health version of higher education suggests a model in which we might have global networks of teaching and learning communities, with people involved synchronously and asynchronously, meeting face-to-face and virtually, and contributing knowledge to the community as well as learning from it.

Education, in that light, becomes less about experts delivering knowledge, as both traditional courses and MOOCs still largely assume, and more about communities of people sharing knowledge, with the educator playing more of a facilitation role, coordinating, editing, and at times conducting the many people learning, teaching, and teaching themselves to learn. Like MOOCs, the financial model for such a networked system remains not yet entirely clear, but the more real value the "flipped" academy generates in terms of educated and empowered people, the more capital it will attract, as happened when public health, at first a nearly pro bono activity of doctors, started to demonstrate the value of this work. Ironically, the health of higher education, in the public's eye, may depend upon how much higher education models itself on public health.

Thomas Fisher is Dean of the College of Design at the University of Minnesota.

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