A systems map for a course in environmental health

A new model of learning: Environmental health in a global world

In the summer of 2018, the NYU School of Global Public Health redesigned the undergraduate environmental health course that is required of all public health co-majors at NYU. Our idea was to develop a course that combines competency building with opportunities for students to propose their own strategies to mitigate the health effects of environmental threats.

We taught the revamped course in the fall of 2018 to 80 students split into two classes. At the outset, we informed the students that we were trying a new way of teaching environmental health and that their feedback was important to us. This created an unusual partnership between the faculty and the students in trying to deliver an effective course. The result was a novel and effective learning structure that can be replicated across multiple public health disciplines.

The course begins with an introduction to systems thinking, including visual representation of factors that contribute to complexity in systems. Systems thinking prepares students to recognize how all environmental health challenges are complex and the result of multiple political, social, economic, and other factors. By analyzing the interactions between these factors, students can then evaluate the result of multiple strategies for addressing health challenges, and predict the consequences—both intended and unintended—of actions meant to improve health outcomes.

Through a series of modules in which teams first create a systems map, then propose a strategy to improve the outcome of interest, and then present that strategy to the rest of the class, the students develop skills in critical systems thinking and presentation, all the while developing a deep understanding of the environmental challenge at hand. The modules include smoking, lead in water, air pollution, gun violence, climate change, planetary health, and health security. Teams are asked to confine their analysis to a particular geographical boundary (a country or a city, for example).

To add another layer of difficulty, and to ensure that the teams consider multiple perspectives, each team member is assigned a role with a particular viewpoint on the challenge. One team member approaches the problem from the perspective of an anthropologist. Another plays the role of an economist. The remaining members assume the views of a policy/government official, an epidemiologist, an engineer, and an environmental scientist. We called these roles the students’ avatars, which they liked very much.

Our initial concerns included:

  • Would students embrace the concept of systems thinking and learn to draw a systems map that shows the interaction between the complex factors that influence the outcome of a system?
  • Would they engage in the level of cooperation and research necessary to understand an environmental topic (lead in water, for example) enough to draw a useful systems map?
  • Would they be comfortable analyzing their map to propose potential strategies for improving outcomes?
  • Could they learn enough about their avatar to feel confident in expressing that perspective?
  • Could they create a persuasive case for implementing an innovative strategy to reduce adverse health outcomes related to an environmental challenge?
  • Would they be able to do that five times during the semester and maintain a high standard of performance?

Thankfully, after teaching more than 450 students in this model over seven semesters (four of them during a pandemic), we know that NYU undergraduates are able to more than meet these challenges. The class has now become an effective and popular addition to the GPH curriculum.

Chris Dickey, DrPH, MBA, leads the Global and Environmental Health Program at NYU’s School of Global Public Health (NYU GPH). William N. Rom, MD, MPH, is a research scientist in climate change at NYU GPH. Lori Hoepner, DrPH, is adjunct faculty in the Global and Environmental Health Program at NYU GPH.