Explaining the origins and distribution of health and disease: an analysis of epidemiologic theory in core Master of Public Health coursework in the United States

Michael Harvey*a & Margaret McGladreyba Department of Health Science and Recreation, San José State University, San Jose, CA, USAb Tisch College of Civic Life and Department of Sociology, Tufts University, Medford, USACONTACT Michael Harvey michael.harvey@sjsu.eduABSTRACTThis article examines the epidemiologic theories taught most frequently in core social and behavioral science coursework in Master of Public Health (MPH) programs in the United States, identifies lacunae, discusses their implications, and recommends specific pedagogical changes. Course syllabi were identified through online search and instructor outreach between June and December 2016. Content analysis was conducted to identify most commonly taught theories. Analysis continued until theoretical saturation. Behavioral health theories predominate within our sample of core social and behavioral science course syllabi. Behavioral health theory represents 93% of the most commonly taught epidemiologic theories within our sample. Individual health behavior theory was the most commonly encountered, the most prevalent of which were the health belief model and the theory of planned behavior, both appearing in 83% of syllabi (n = 25). Theories of interpersonal health behavior were the second-most commonly observed, including social cognitive theory (77%, n = 23) and social network theory (67%, n = 20). Behavioral-ecological theory was present in 87% (n = 26) of syllabi. The fundamental cause theory (23%, n = 7) was the only commonly taught non-behavioral epidemiologic theory. The social determinants of health were referenced in 60% of syllabi (n = 18). Based on this sample, behavioral health theories drawn from psychological, behavioral science, health education, and medical literatures predominate in US-based core MPH pedagogy concerned with explaining the etiology and distribution of health, morbidity, and mortality. We recommend the inclusion of non-behavioral epidemiologic theory from disciplines more engaged with structural aspects of health.