Peer Review

The Evolution of the Interdisciplinary Health and Society Major at Beloit College

The development of the health and society major at Beloit College represents the convergence of student and faculty interests, and of local and national educational trends, within an environment that is flexible and supportive of curricular innovation. Beloit College is an independent liberal arts college of 1,250 students, located in southern Wisconsin, and is not connected to a school of public health. We have been able to construct an interdisciplinary major focused on the big questions of global health and social justice that is built upon disciplinary courses, internship experiences, study abroad, and opportunities for reflection, synthesis, and presentation.

Students who choose the health and society major take a core set of courses related to health and statistics, and then develop a theme that enables them to integrate different perspectives to build their understanding of the complexities of health and health care. In their thematic courses, they study women’s health, development, policy and/or culture and behavior, while developing the critical thinking skills that characterize the best liberal arts graduates.

Beloit College—The Setting for Innovation

How did this major develop, unconnected to a school of public health, at a small liberal arts college? Beloit College prides itself on a curriculum built upon three pillars of interdisciplinary, experiential, and international education. Beloit’s mission and goals mirror the LEAP learning outcomes from the Association of American Colleges and Universities (AAC&U). Beloit has a long tradition of pedagogical leadership and curricular initiatives that bring hands-on activities and real-world problems into the classroom. Faculty members frequently design and develop new courses related to their interests. These engaging pedagogies and courses model the application of theory to practice for our students.

Beloit College’s student body demonstrates a strong commitment to service and social justice. Merit scholarships that reward leadership and community service as well as academic excellence shape the outlook of the entire student body. The students who come to Beloit College expect to engage actively with the community and the curriculum, look to their faculty members as leaders and role models, and eagerly embrace activism. Within this context, several strong students who were studying at Beloit from 1998 to 2004 proposed self-designed interdisciplinary community health majors, expanding upon existing courses in medical anthropology, medical sociology, biomedical ethics, and the biology of disease. These students all had strong interdisciplinary worldviews, clear ideas about what they wanted to achieve, and the writing skills to present their ideas persuasively. They completed majors that demonstrated the value of studying health through diverse disciplinary lenses at the undergraduate level.

We served as the main faculty advisers for these interdisciplinary majors and were excited by the program of study that these students had assembled. We watched them build interdisciplinary connections, critically analyze real-world problems, and link projects between the campus and the community. The courses that formed the foundation for the self-designed majors included many of the key components necessary for the study of public health, including global perspectives; emphases on ecology, population biology; and cultural and ethical perspectives on individual decision making. We recruited other faculty members who were teaching health-related courses and developed a template for a health and society major. At the same time, an overlapping group of faculty members were designing an interdisciplinary environmental studies major. These two interdisciplinary majors were presented to the faculty in 2005 and approved with strong, broad support across the college faculty.

The Curriculum

The core courses of the health and society major engage students in disciplinary theories and practices as they analyze health-related issues. These core courses address many of the objectives identified by AAC&U’s the Educated Citizen and Public Health initiative in the three courses required for a public health minor: Public Health 101, Epidemiology 101, and Global Health 101. The major builds upon the strength of our departments, the flexibility of our curriculum, and the willingness of faculty members to work with students who are not majoring in their department.

Because the core courses existed before the major, we were able to accomplish the development of the new major program without new faculty lines. The program has increased demand for the core courses, supporting courses, and courses in statistics; to date, faculty from departments such as psychology, biology, anthropology, and international relations have been willing to accept health and society majors into their classes. As the major has grown, however, it has created enrollment stress for the supporting departments and raised questions about institutional commitment.

The major consists of fourteen four credit hour courses (fourteen Beloit College units). Each student takes two introductory courses in the social sciences, two in the natural sciences, a statistics course, a midlevel science course, and three core courses. The core offerings and the departments that offer them include:

  • Health, Medical Care and Society (sociology),
  • Medical Anthropology (anthropology),
  • Biomedical Ethics (philosophy),
  • Emerging Infectious Diseases (biology),
  • Women’s Health (interdisciplinary studies), and
  • Nicaragua in Transition: Health and Microcredit (interdisciplinary studies).

Together these courses address health at the individual and population levels, cultural norms and social institutions, and the ethical challenges that face individuals, health care practitioners, and policy makers. Epidemiology is introduced in Emerging Infectious Diseases and reinforced in Medical Anthropology and Health, Medical Care and Society. The cultural relativism discussions that occur regularly in Medical Anthropology complement the ethical analyses student undertake in Biomedical Ethics. Each of these courses analyzes issues in health and health care, including social disparities, the emergence of new diseases, the role of culture in decision making, and the relationship between development and health. Many of the courses are offered in the spring semester, so students often take several at the same time, building a cohort of engaged students that helps them create interdisciplinary linkages. In these courses, students have engaged in real-world analyses—interviewing community members about their views of death and dying, constructing a “pandemic influenza plan” for the college, and working with agencies providing women’s health services.

Each student majoring in health and society proposes a theme that consists of four related courses and an internship. Using courses at Beloit College and approved off-campus programs, students majoring in Health and Society have developed a range of themes including nutrition, women’s health, and health and development. Their internships in Beloit, through the Wisconsin Community Health Internship program, and participation in study abroad programs complement these themes. Each student takes a senior capstone course that includes a group project in the community. Recent projects have included a community needs assessment, preparing resources for elder care, and working with local schools on nutrition and wellness. Seniors also write a reflective summary of their learning and its connections to their future. (More information is at www.beloit.edu/heal)

Students have both created the model for the health and society major and collaborated with faculty to expand the curriculum by adding content to existing courses and developing new courses. For example, students organized a senior seminar on Health and Human Rights that brought international relations and health and society students together to imagine strategies for dealing with complex questions of health and social justice.

Nicaragua in Transition: Health and Microcredit, now included as a core course, was first proposed by a student who had returned from a service-learning experience. After taking Nancy Krusko’s Medical Anthropology course, centered on poverty as a pathogen, the student recruited Krusko to accompany her to Nicaragua. In collaboration with the Office of International Education, they developed a course in which students focus on “place” as a variable in health, using ethnographic tools first to study the city of Beloit and then applying these tools to study the role of microcredit and poverty reduction in Nicaragua. To date, three groups of students have taken this course, including its spring break study tour in Nicaragua.

The Health and Society students at Beloit College have had an impact on the larger college curriculum. In classes across the disciplines, these students have expressed the desire to write their papers on health-related topics. Many faculty members have responded by encouraging these papers and by adding course content to address health issues. The international relations instructors, for example, have added cases about international public health. In peace studies, the professor has included discussion about the Cuban medical system and medical outreach in Africa as a powerful example of “positive peace.” Faculty members have commented that health and society students are rewarding to teach because they are willing and eager to examine contrasting explanatory models, to integrate across disciplines, and to discuss their experiences from community service and study abroad.

Collaborations with the Office of International Education enable students to find programs of study that complement their studies on campus. Seventy-five percent of health and society majors study off campus for at least one semester. They participate in Beloit College’s Cities in Transition programs that include opportunities to study nutrition and community health in Quito, Ecuador, and HIV/AIDS advocacy in Dakar, Senegal. Many students participate in third-party provider programs that highlight public health and community development; they have studied health care in Denmark, maternal mortality in Tanzania, sanitation in Thailand and public health in Chile. Students have also studied urban health in Chicago while participating in the Associated Colleges of the Midwest program.

The health and society major includes opportunities for students to reflect upon their off-campus learning as they prepare presentations for the Annual International Symposium in the fall and the Annual Student Symposium in the spring. Recent presentations by Health and Society majors have included

  • Si, Se Puede: The International HIV/AIDS conference in Mexico City
  • Before Globalization We Were Poor, But We Had Our Dignity: Stories of health around the world
  • So Much More Than Trash: Alternative education in an urban slum in Thailand
  • Sangomas: The intersection of culture and medicine in South Africa

Assessment:

The health and society major at Beloit College has grown from three graduates in 2006 to sixteen graduates in 2009. Students have told important stories about hope and the potential for change; their education has been intentionally interdisciplinary, and they have traveled the world to learn about culture, public health, and community development. Their studies have taken them to Nicaragua and Ecuador, Kenya, South Africa, Thailand and China, and Baltimore and Chicago. Half are fluent or nearly fluent in a second language. All have studied statistics, participated in a significant internship or service-learning project, and worked together with classmates and community members in their learning. This program has engaged students with the big questions, enabled them to craft complex responses, and encouraged them to reflect on issues of ethics and social justice. One graduate summarized the experience saying, “I believe that the program sparked in me an intense interest in research, intervention, and policy. I feel as if I have a lot more to learn that I can only learn in practice. I also feel like the program provided me with the tools and critical thinking skills to understand and possibly address the complex relationships that exist in healthcare today.”

Of the sixteen students who graduated in 2006–09, seven are presently enrolled in graduate programs in public health. Several are preparing for careers in nursing. Eight are working, or worked before graduate school, in community advocacy positions related to health. One graduate is now in Kenya on a Rotary International Ambassador Fellowship.

Future Challenges

As this major grows, it faces challenges in staffing, access to limited resources, and negotiating its position in the institutional structure. Its appeal to students and faculty has challenged us to consider the structures that support interdisciplinary study, and explore broader questions of innovation within our academic borders.

Students who have taken advantage of the opportunities provided by this major feel that they are, in the words of one graduate, “intellectually promiscuous.” Their skills and knowledge enable them to view the complexities of global health issues with hope rather than despair. They are, in our view, intellectually empowered.


Marion Field Fass is a professor of biology; Nancy Krusko is a professor of anthropology—both of Beloit College.

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