Cases Studies in Public Health Available Online

Case studies aren’t just for business schools anymore. Columbia University’s Mailman School of Public Health has been using the case method to teach MPH students as part of the new Columbia Public Health Curriculum. Now, six of the School’s public health cases have been published online, making them available to classrooms anywhere.

“The case method can be a powerful tool for learning public health. It gives students the opportunity to gain experience making decisions in the face of uncertainty, much as they will have to do every day when they graduate and leave us to work in their chosen field,” says Melissa Begg, ScD, Vice Dean for Education at the Mailman School, who is leading the implementation of the new MPH curriculum.

The result of candid interviews with officials at the World Health Organization, U.S. Centers for Disease Control, and city and state departments of health, the Mailman School case studies explore complex issues in public health from managing the SARS outbreak in Asia to regulating trans fats in New York City restaurants. (Synopses below.)

Each case study tells a detailed story which stops mid-action, asking students to imagine themselves into the shoes of a decision-maker facing a tough call. One case developed with the help of David Abramson, PhD, assistant professor of Sociomedical Sciences, looks at the decision of whether to evacuate two hospitals during Superstorm Sandy. Another looks at how to win a community’s trust, as told through the experience of Mailman scientists conducting a federally-funded study of arsenic-tainted water in Bangladesh.

Classroom discussions are lively, and most important, there isn’t a single right answer. “Students practice taking positions and defending them based on the available evidence, while developing communication and critical thinking skills,” explains Dr. Begg. “They learn to argue persuasively for their points of view.

The Mailman School case studies are available through Columbia University’s Case Consortium website, which also features cases by Columbia’s Journalism School and the School for International and Public Affairs (SIPA). They are available free (after registration) to educators and at a nominal cost to students, professionals, and other interested parties. 

“While most existing case curriculum remains paper-based, the Mailman School cases are online and multimedia, meeting students where they live in the digital media world,” says Kirsten Lundberg, MPA, director of the Case Consortium @ Columbia.

The “discussion-based” case study approach has historic roots reaching back to Socrates, and was popularized in the 20th century by business schools. To see the cases, please visit Case Consortium and click on Cases.

Public Health Case Studies

Voluntary or Regulated? The Trans Fat Campaign in New York City

This case takes students behind the scenes in the world of public health policymaking.  Students follow the New York City Department of Health and Mental Hygiene, and the process it went through to craft a policy to reduce public consumption of trans fats in restaurants. In 2005, after considerable internal negotiations, the department’s Bureau of Chronic Disease Prevention and Control elected to launch a public awareness campaign aimed equally at consumers, restaurants and their suppliers. But after a year, the awareness campaign had not budged the rate of trans fat use in restaurants. In 2006, the department decided to resort to regulation, despite the risks of triggering protests of a “nanny state,” not to mention pushback from industry.

When BEST Intentions Go Awry: Arsenic Mitigation in Bangladesh

This case is about a public health response to the widespread arsenic contamination of groundwater in Bangladesh. It examines the lead-up to a 2008 media crisis that confronted a Columbia University clinical trial of a potential treatment for arsenic poisoning. The case raises for discussion the challenges of conducting research in rural, less developed and culturally insular communities. It also asks how to help communities while studying them—complicated by funding restrictions and a possible skewing of results. 

Community Savings, or Community Threat? California Policy for Ill and Elderly Inmates

This case looks at the challenges that confront public health professionals who work in a corrections environment. By 2011, a court-appointed Receiver had made progress in fixing a broken system of medical care for prisoners in California. But costs spiraled ever higher for elderly and ailing inmates. Public health officials had to balance competing public priorities: save taxpayer dollars while treating patients. A new law allowed the sickest prisoners to move to community-based care—but now public health doctors had to decide: who qualified for medical parole?

Credible Voice: WHO-Beijing and the SARS Crisis

This case study takes students into the Beijing office of the World Health Organization as it dealt with the SARS crisis in early 2003. The WHO serves as the world’s monitor of disease outbreak and control. It is able to mobilize legions of the world’s best scientists to analyze, diagnose, prescribe treatments for and contain diseases. However, it depends on the cooperation of the countries experiencing an epidemic. What happens when that cooperation is limited or nonexistent?

The Elusive Tuberculosis Case: The CDC and Andrew Speaker

This case explores the ethical and logistical challenges that doctors face when an infectious disease patient does not cooperate with advice to stay out of public spaces in order to protect the general welfare. In April 2007, a young Atlanta lawyer, Andrew Speaker, was diagnosed with active tuberculosis. Initially cooperative, Speaker departs without notice for Greece and his scheduled wedding even though it is clear that his strain of TB is more lethal and difficult-to-treat than anticipated. 

Evacuate or Stay? Northshore LIJ and Hurricane Sandy

This case examines the pros and cons of evacuating medical facilities in the face of a looming natural disaster. In October 2012, the North Shore-Long Island Jewish Hospitals (North Shore-LIJ) network braced—together with rest of the East coast—for the advent of Hurricane Sandy. Weather forecasters painted a grim picture, and North Shore-LIJ had three hospitals in low-lying areas. Vice President of Protective Services James Romagnoli and COO Mark Solazzo had seen this scenario only a year earlier, when in August 2011 they evacuated hospitals in advance of Hurricane Irene. But Irene had, at the last moment, spared New York City. With that unnecessary evacuation fresh in their minds, the two officials had to decide what to do as Sandy approached.