Understanding health using collective and multidisciplinary methods

The Covid-19 pandemic has put public health at the heart of global preoccupations. At the University of Bordeaux, the Bordeaux School of Public Health (ISPED) is a major player in public health education in France, and is internationally recognized for its academic excellence. An update on public health challenges and their dedicated training offer with Simone Mathoulin-Pelissier, Director of ISPED and professor of epidemiology and public health.

  • 20/10/2020

Institut de Santé publique, d’épidémiologie et de développement (ISPED) Institut de Santé publique, d’épidémiologie et de développement (ISPED)

What exactly is public health? What are the fields of action of this discipline distinct from medicine?

The field of public health strives to improve, promote and restore health, and is based on collective and multidisciplinary reasoning. Public health professionals aim to respond to major societal and health related challenges affecting the population, by determining what factors cause illnesses (including epidemics) and how to prevent them. Why are we sick? What can we do in order to not be? Which populations are most vulnerable? How can we improve health in general or reduce disabilities? What actions can we propose? How can we implement and assess them?

To answer these questions, public health involves many disciplines, such as epidemiology, biostatistics, information and technology, management/administration of health organizations, economics, social and human sciences, and many more, all of which we teach at ISPED. Our public health Master program includes over 10 specialist tracks corresponding to the needs of different players of professional healthcare at large or in research.

What are the specific features of ISPED?

ISPED has its own distinct identity. The University of Bordeaux is the only institution in France to have created, in 1997, a school of public health separate from the Medical Science Faculty. This was quite forward-thinking at the time! The international openness of this institute, especially to developing countries and the African continent, is also remarkable. Our courses (initial training or lifelong learning) are offered in both face-to-face teaching and distance learning. In fact, a quarter of our students are international (75% of whom are from the African continent), and as some are not able to travel to Bordeaux, we implemented e-learning very early on.  We are quite a few steps ahead…

Each year, ISPED trains more than one thousand students in the different public health professions: prevention and health promotion, health education, occupational health and environmental health, international health, medical informatics, management of health organizations… as well as epidemiology and biostatistics, of course.

Our programs are accredited and of high quality as they are also closely linked with the Bordeaux Population Health center, a center for public health research. Many of our professors are also researchers at the center and our students can carry out their Master and doctoral work placements there. ISPED is also in contact with players from the health and medico-social world and with various regional and national partners.

Through knowledge transfer, discussions between training actors, research and action and decision-making, we are able to contribute to public health policies. With this in mind, we proposed a seminar on Covid-19 with ARS Nouvelle Aquitaine to share knowledge and develop action plans. Finally, we intend to certify our courses internationally and are working towards this objective for our Master programs with the support of the Initiate of Excellence, modeled on American public health schools.  

What are the repercussions of the Covid-19 epidemic for ISPED?

Applications for the first year of the public health Master program have increased, rising from 700 to 1,000. Concerning distance teaching, we were well prepared, because while the “Covid effect” brought distance learning into fashion, at ISPED we have been doing this for the last 20 years! We currently have 600 people following our university diplomas (DU) across the world.

Another fact revealed the importance of health needs: during lockdown, some students from the “management of health organizations” track who were on work placements in nursing homes were recruited on fixed-term contracts, because these establishments were so desperate for trained public health staff! And our “Enquêter sur la santé” (Investigating health) MOOC (Massive Open Online Course), which has been in place for 4 years, has had unprecedented success.

Finally, and given the current importance of prevention, a new university diploma on prevention and health promotion has been put in place since the beginning of October to train professionals in the field, which is obviously very useful for the current crisis. This course was very much at the instigation of Santé Publique France, who funds a teaching chair at ISPED.

More generally, what lessons have you learned from this health crisis?  

France, like other countries, has had several stages of epidemiological transition. In the past, we suffered from infectious diseases linked to poor hygiene and different viruses, often in young populations. Then came chronic illnesses (long-term illnesses like cancers, Alzheimer’s disease, cardiovascular diseases, etc.) which were also very worrying, and also what some called “social” illnesses, related to tobacco, alcohol and also car accidents. And now, with Covid-19, for the last 8 months we have been facing an infectious type of crisis that we must counter urgently and in the long term, with the need to take vulnerable individuals into account.

In public health the notion of uncertainty is one that has to be understood and we must accept that we must constantly update our knowledge as insights and practices evolve and solutions must be adapted in accordance. It is therefore essential to consider the context when managing this health crisis: social determinants, insecurity, overpopulation, living conditions, environment, etc. As a result, the overall situation in China or America is not exactly the same as in Europe. In addition, the current crisis has highlighted the advantage of a general approach to global health, with some recommending the “One Health” perspective, which affirms the interdependence of ecosystems, animal and human health as a whole and promotes a collaborative and transdisciplinary approach.

For the time being, however, we have to prepare to live with this virus, probably for another year, if not more. Today, the most urgent matter is to anticipate in order to avoid overwhelming hospital services. To do so, public health and prevention have a more important role to play than ever: we must test, trace, isolate, of course, but also inform and help, support and continue to gain a better understanding of the natural history of this disease. In the near future we must also prepare for the hoped-for arrival of one or more vaccines or curative treatments and think about the organization, information and acceptability by individuals and the population as a whole. This pandemic will of course be used as a source of information to illustrate our teaching as it is always our intention to be anchored in the reality of public health needs.

Bordeaux School of Public Health

The Bordeaux School of Public Health (ISPED) is the first school of public health in France, and is separate from the Medical Science Faculty. Created in 1997, its aim is to contribute to tackling the major challenges faced in contemporary public health: increasing life expectancy, overhauling health systems, the resurgence of infectious diseases in the world, the impact of industrialization and globalization on the environment and the health of populations. ISPED is historically linked with the “Bordeaux Population Health” research center.

 ISPED in numbers

  • 34 diplomas (21 university diplomas, 2 first year Master programs and 11 second year Masters)  + 1 MOOC + 1 summer school
  • nearly 1,000 trainees/year (including 2/3 of lifelong learners) of which 300 are enrolled in Master programs
  • 76 lecturers and lecturer-researchers dedicated to training and 30 administrative staff

Note: the previous Director, Geneviève Chêne, is now Director of Santé Publique France. The founder, Roger Salamon, is the former President of the French High Council for Public Health.

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Simone Mathoulin Pélissier

Simone Mathoulin-Pelissier, Director of ISPED and professor of epidemiology and public health.