For a Global Generation, Public Health Is a Hot Field

"It would not have happened without AIDS," said Thomas Coates, head of the global health program at the University of California at Los Angeles, describing the new interest in public health.

AIDS is a dramatic example of how whole populations, not just individuals, can be at increased risk for disease -- a key epidemiological concept. The emergence in the mid-1990s of life-extending treatment, which is only now being brought to Africa and Asia, where most AIDS patients live, provides a lesson in equity -- the principle that underlies public health.

"It took something like HIV/AIDS -- because it is so lethal and now that it is so treatable -- to capture our attention and make us realize that there were such inequities in the world," Coates said.

But the benefits of studying public health go considerably beyond understanding infectious disease.

The concepts introduced in basic epidemiology courses include causation and correlation, absolute risk and relative risk, biological plausibility and statistical uncertainty. Nearly all health stories in the news -- from the possible hazards of bisphenol A in plastics and the theory that vaccines cause autism, to racial disparities in health care and missteps in the investigation of tainted peppers -- are better understood with grounding in that discipline.

Other forces driving interest in public health include the Internet's ability to put students in touch with far-flung people and institutions, and the expectation at many colleges that students will study or work abroad.

Observers also credit a flowering of social consciousness in today's students. While the causes of their parents' generation were fueled by protest and relied heavily on symbolic victories, the interest in public health reflects this generation's more communitarian and practical outlook.

"There is a very idealistic aspect to this -- the idea that 'I am living in this world, and it could be a better place,' " Riegelman said. "This is a student-driven movement. The drive is not just intellectual, it is passionate as well."

Kelly Gebo, an infectious-diseases physician who directs the public health major at Johns Hopkins, said that in the past, college students who wanted to do something about global health were limited to collecting money, sending it to UNICEF and hoping for the best.

"Now they can get on a plane, get off in Cape Town and help out in a clinic," she said. "They aren't happy with just collecting pennies. They want to do stuff."

Joanna Stephens fits that description well.

A fifth-year senior at William and Mary, Stephens, 21, spent two spring vacations helping deliver medicines to a charity in Ghana. The team of 16 students -- she led one of the trips -- raised money during the year to pay for the drugs. The receiving clinic was run by Ghanaian health workers. "We were not dropping out of the sky with American doctors," she said.