Question the questions: Global Public Health program holds kickoff event

Healthcare decisions aren’t always rational.

In the common model, a medical expert provides information to the patient, who then follows their advice, noted Collins Airhihenbuwa, a global public health scholar with more than 30 years in the field. But look back at the height of the coronavirus pandemic, when individuals were swayed against vaccination by influencers who sowed doubt and suspicion of science — some of whom claimed to be doctors themselves.

“The context matters; how people frame their decisions and what is important to them has to be part of how we understand global health,” he said.

The global contains the local, Airhihenbuwa told students during the Aug. 22 kickoff of Harpur College’s new degree program in global public health. The event’s keynote speaker, Airhihenbuwa is a professor of health management and policy at Georgia State University, where he leads the interdisciplinary Global Research Against Non-communicable Disease initiative at the 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 Our Differences, the Crisis of Global Health and Politics of Identity.

More than 80 students have already declared global public health majors since the program began in the previous academic year. A few even graduated last May, including Yasmeen Gilani, who traveled to Ghana to conduct research and is now a master’s student in international health policy at George Washington University, said Binghamton University President Harvey Stenger.

“We’ve had a number of incoming students who said that they chose Binghamton specifically because of this program. I expect that to grow even more in the years ahead because Binghamton tends to attract bright, capable students who aren’t afraid of a challenge and who are committed to making a difference in the world,” Stenger said.

The major has three tracks: a bachelor of science, a bachelor of arts and a bachelor of science specifically for future healthcare providers. The degree is flexible and globally focused, allowing the students to take internships and conduct research outside the U.S.

While scientific and medical approaches to healthcare and aid are critical, researchers and healthcare practitioners need a broader base of knowledge and understanding to tackle obstacles to care around the world. That includes governments and non-governmental organizations, and cultural, religious and political obstacles to care, Stenger said.

To that end, GPH provides graduates with experience in five core areas: epidemiology, biostatistics, health systems and policies, environmental health, and social behavior theories.

“This is a different kind of major,” said Chair and Associate Professor of Africana Studies Titilayo Okoror, the founding director of the GPH program. “Global Public Health gives you the skills and core courses of public health, but within a social justice framework.”

‘Comfortable with the uncomfortable’

As a discipline, global public health relies on context, narrative and positionality, Airhihenbuwa said. Ultimately, humanity must be central to engaging with and trying to understand different cultures.

“I often refer to the Native American expression that says the longest journey you ever take is the journey between your head and your heart,” Airhihenbuwa said. “The journey of global public health is actually a journey toward yourself, to the extent that you are able to dislocate yourself from the familiar and understand otherness from a perspective that is positive and unique.”

To demonstrate context, Airhihenbuwa asked how many Binghamton University students come from upstate New York; several hands went up. How about downstate? New York City? Somewhere in between? When people say the words “New York,” what geographic space do they mean? The context — knowing precisely where someone comes from — shapes the conversation and alerts us to potential differences, he said.

To explain the concept of positionality, Airhihenbuwa posed another question: Who are you outside of what you do?

His answer: He is a father, husband, uncle, brother, teacher and, above all, a student. He is both Nigerian and American — which is somewhat fraught, considering that he is often told that he’s “not really from here” in both contexts. People can and do occupy multiple spaces and identities, he said.

Healthcare providers see patients in a vulnerable state that doesn’t represent the totality of who they are, he reminded students.

“When we engage, whether in this country or any country, we engage people at the level of who they are,” he said.

Anti-racism and decolonization are key parts of global public health — but that doesn’t mean these principles are limited to faraway places. Individuals in the field should also be concerned about health outcomes in New York or the U.S. — whichever communities are local to them.

“Be comfortable with the uncomfortable,” he advised. “You have to be okay with self-reflexivity, where you question your own position. That is a part of healthy learning.”

The skills and knowledge that students acquire in global public health are applicable in many contexts, including their own hometown and where they go to school. After all, Binghamton is located in one of the poorest metropolitan areas in New York state, noted Provost Donald Hall. He’s familiar with how social conditions can contribute to health challenges; he grew up in rural Alabama, where people didn’t have access to housing or clean water.

“The connection between what we see here and what other parts of the world experience is that concept of ‘global.’ It’s why we should be so devoted to issues around global public health because it’s our health, as well as the world’s health,” Hall said.