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A quarterly journal

A A of new ideas and


practices in
undergraduate
education

Volume 2, Number 3
Spring 2000

In this Issue

Health in a Liberal
Education

The Health of Our


Students: What Do
We Know?

Campus Resources

AAC&U News

Published by
the Association
of American
Colleges and
Universities
peerReview
A quarterly journal of new ideas and

Contents
practices in undergraduate education

Spring 2000 Volume 2, Number 3

Published by the
Association o f American Colleges and Universities
1818 R Street, NW Washington, DC 20009
Tel. 202/387-3760 www.aacu-edu.org

Executive Editor
Joann Stevens

Editor Point of View


Rafael H eller

Cover Design 4 "And there is no health in us": Health in a Liberal Education


Cynthia Olson by Wm. David Burns

Production Editor
Julie Warren
10 Higher Education's Role in Public Health
by Robert E. Fullilove and Mindy Thompson Fullilove

Peer Review Advisory Board 14 Beyond the Campus Clinic: A Holistic Approach to Student Health
James A. Anderson by Richard P. Keeling
North Carolina State University

Randall Bass
Georgetown University
Resources
David A. Berry
Community College Humanities Association

Norman Coombs
15 The Health of Our Students: What Do We know?
Rochester Institute of Technology

Peter Ewell
National Center for Higher Education Management Systems
19 Resources for a Healthy Campus

Ann S. Ferren
Radford University

Mildred Garcia
AAC&U News
Arizona State University West

Richard Guarasci 22 Headlines


Wagner College

Eiise B. Jorgens
Western Michigan University
25 AAC&U Resources

Adrianna J. Kezar
ERIC-Clearinghouse on Higher Education 26 Calendar

Ann Leffler
Utah State University
27 Reality Check
Donna Maeda
Occidental College

David E. Maxwell
Drake University

Catherine Hurt Middlecamp


University of Wisconsin-Madison

Chandra Talpade Mohanty


Hamilton College

John P. Nichols
Saint Josephs College

G. Roger Sell
acknowledgements
University of Northern Iowa
Thanks to the U.S. Centers for Disease Control and Prevention Division of Adolescent and School
Joan Straumanis Health for its support of AAC&Us Program fo r Health & Higher Education.
U.S. Department of Education

Beverly Daniel Tatum


Mount Holyoke College
FROM THE EDITOR

If theres any truth to the hospital dramas we see on television,


the emergency room is an awfully busy place. Unless youve got chest pains or a head wound, you might waif for hours
to get the attention you need. But when your turn does come, the doctors will leap into action, with scalpels dancing
and monitors beeping and everybody racing furiously to put you back together again.
Its much the same scenario when the topic of college health comes in for treatment by the news media. Consider,
for instance, the case of binge drinking. For decades, higher education has struggled with the problem of campus
alcohol abuse, while attracting few headlines and only scattered interest from the general public. Now that the media
spotlight has turned this way, though, everybody seems to be up in arms over the issue. Fraternity parties and alcohol-
soaked violence have become the stuff of lurid exposes, angry editorials, and the nightmares of frightened parents
and anxious administrators.
Not to suggest that the binge drinking crisis has been exaggerated. Certainly, alcohol abuse demands serious inter
vention by colleges and universities. Indeed, the Harvard School of Public Healths 1999 College Alcohol Survey shows
that roughly 40 percent of the nations college students engage in dangerously heavy drinking, and the rate has
remained at that level for many years.
Our concern, though, is that higher education relies too much upon a triage system of management. When a health
crisis captures our attention, we throw time, money, and effort into finding a cure. But we rarely listen to our colleagues
in the public health professions, who warn us that no symptom is discrete. We
might even say (and pardon the expression) that health is contagious. A condi We tend to imagine
tion such as binge drinking may seem to have flared up out of nowhere. But if
we truly wish to grasp its meaning, then we must learn to account for its relat health to be
ed phenomena, such as the dating habits of young people, the influence of mar
keting agencies, the legacy of academes in loco parentis doctrine, the cultural somebody elses business.
significance of boredom, and so on.
To the extent that we fail to achieve a holistic perspective on health, we will do little to address students most seri
ous health concerns, such as alcohol abuse, date rape, smoking, and sexually transmitted disease. In fact, as Richard
Keeling argues in this issue of Peer Review, the best approaches to promoting student well-being are not medical inter
ventions at all. Health doesnt confine itself to the health center. Rather, it spreads across and emerges from our cul
tural values, educational practices, and institutional priorities.
Yet, in our roles as faculty, deans, provosts, and presidents, we tend to imagine campus and community health to be
somebody elses business: it belongs to student services, or maybe the director of housing, or even the local govern
ment. In short, and as Robert Fullilove and Mindy Thompson Fullilove describe, we too readily deny our own parts
in the collective responsibility for public health, and we too often fail to notice when our own ignorance becomes
somebody elses tragedy.
Finally, as David Burns suggests, we may wish to expand our frame of reference even further, beyond a concern
with student and community health problems. In fact, we need not see health as a problem at all. Rather, as teachers
and students, we might choose to explore the many other meanings of health, conceived not as an impending crisis
but as a productive force and a positive value in its own right. We might ask, for example, how does the desire for health
figure into our cultural practices, our historical events, and the key political, religious, and ethical debates of our time?
If we wish to provide a truly liberal education, mustnt we help our students to understand the significance of health
in their own lives and in the lives of those around them? PI

Association of American Colleges and Universities AAC&U peerRevietv SPRING 2000 3


POINT OF VIEW

And there is no health in us


Health In a Contemporary Liberal Education
by Wm. David Burns, Senior Policy Director, AAC&U, and Director of the Program fo r Health and Higher Education

W hen I was a c h il d , a general confession in the provocative; it points to the common interests of students, faculty, staff, and
Book o f Common Prayer' of the Episcopal Church local communities; and it challenges the conventional separation of body
contained these three declarations; from mind. In short, a curricular focus on issues of personal and public
health can serve exceptionally well to generate the sort of rich, connected,
We have left undone those things which
liberal learning that so many of us advocate.
we ought to have done;
And we have done those things which we Health: A way of remembering the body
ought not to have done; Puzzled by the health behaviors and decisions of undergraduates, decisions
And there is no health in us. that can have long-term consequences for their lives, a university president
Mercifully, we were invited to employ the collective we to signify our once told me, We know fairly well what our students have learned, but we
own individual contrition and our own inevitable failings. And this rhetori dont know who they are This follows from higher educations bias towards
cal conceit also reminded us that the consequence of these failings was an cognition, he argued, pointing to the seemingly clean separation of minds
absence of health in us in our individual selves but also, significantly, in from bodies, as well as to the corollary separation of thoughts from feelings
our community. What health might be, exactly, we never specified. But and ideas from material things.
week in and week out, we asserted As an organizational strategy, these

that it was both personal and collec distinctions appear to be inevitable. If

tive property, and that it depended on Our bad habits we are to cope with lifes complexities,

both the things we had done and that we see no choice but to divide them

which we had left undone. tend to be not managerial into smaller pieces and to assign them

This old rubric still speaks elo to distinct parts of the institution. For

quently, I think, to the significance of but conceptual. the persons involved, however, these
maneuvers amount to a sort of disin
health in our lives, both as individuals
and communities. And it speaks to tegration, what we might call an offi

many institutional contexts, including not just the church but also higher cial process of dismemberment. In order to help students to complete the
education. Indeed, for the past four years, I have been working with AAC&U curriculum, for instance, we require them to take themselves apart, dividing
colleagues and member campuses to explore healths place in academia. themselves into and among units, programs, and majors. If the whole, living
Specifically, our goal is to increase the likelihood that college students will body is tended to at all, it is transferred out of the curriculum altogether,
encounter issues of health within the undergraduate curriculum. assigned to the care and supervision of the department of student affairs. The
My own goal, in this essay, is to reflect on what weve learned so far, as well body itself more or less vanishes from the classroom (though it may re
as to describe the ideas that motivated this work in the first place. The study appear mindlessly, some would say in a host of other places and chal
of health, I believe, can be a means of creating a more coherent undergradu lenges, in and around campus).
ate experience. As an integrating concept, it bridges seemingly disparate From time to time, when the pathologies of student life such as alcohol
fields of study, joining them in ways that are robust, challenging, and abuse, sexual violence, drug addiction, and so on weigh heavily upon us, we

4 AAC&U peerRevietv SPRING 2000 Association of American Colleges and Universities


POINT OF VIEW

may find ourselves yearning for the As a subject for study, health Health is not, of course, the only new requirements in already-
classical, integrated ideal of a sound invites dialogue among medicine topic that can be used to foster this swamped general education pro
mind in a sound body We may go so and literature, economics and reli sort of interdisciplinary work, but it grams. And we need to resist the
far as to endorse wellness programs gion, campus and community, acad does serve this purpose particularly temptation to propose a rigid canon
or even to lament the loss of physical emics and real life. It lends itself to well. And given the significance of of literature or classroom activities,
education requirements. But reform courses and programs that blend genetic mapping, global warming, or to reduce our goals to a specific set
ers rarely argue that the goal of inte biology with political science, socio AIDS infection, cancer research, and of behavioral outcomes. Nor should
grating mind and body warrants any logical theory with campus health on and on, health will continue to we focus our efforts on the purely
real changes in the curriculum. After practices, the loftiest of ideas with play an especially provocative role in instrumental benefits of health edu
all, contrary to the ancient ideal, we cation. Rather, we should encourage
know that some dull minds exist in health to serve as the broad, multi
what seem to be sound bodies; and layered category that it is, involving
we also know that some good minds both content and analysis, both mind
inhabit bodies that wouldnt qualify and body, and both our curricular
as especially sound. While the mind and co-curricular lives.
may be corruptible, it is also per My inclination is not to prescribe
fectible and, thus, worthy of a higher specific curricular models but, rather,
education. The body, however, is quite to provoke and support the democra
the opposite, either corrupted already tic process of deliberation. Thus, Ive
or, despite the best efforts of modern chosen not to offer a strict recipe
medicine, destined to decay for academic reform. Instead (and
Suppose, however, that we wanted more usefully, I believe), what follows
to take the integration of mind and are some observations that my col
body a bit more seriously, not as an leagues and I have made in the
abstract ideal, but as a reasonable course of our work. The remainder of
ambition for curricular reform? It is this essay is meant to serve as food
here that health can serve us, since, for thought, offering ideas that might
as it has been figured in the Western inform local efforts to integrate
tradition, the personal landscape of health into the curriculum.
health is the body. When we think
about the former, we cannot help but Reasons and rationales:
think about the latter, as well and the most pressing of students con our public debates and private lives
The health that is in us
its not just bodies in general that cerns. Further, it is easily brought into for some time to come. If we choose to give health a promi

come to our attention but also specif existing efforts at building curricular But if we agree that the study of nent role to play in higher education,

ic bodies, both our own and those we coherence. For example, we can inte health deserves to be integrated into then we ought to begin by looking to

see around us, in the classroom, on grate issues of health into writing the curriculum, then it matters a see what roles it might already be

campus, and in the surrounding classes, learning communities, cours great deal how this happens. We playing. In fact, it appears in a num

community. Discussions of health es that introduce science to non-sci need to keep in mind that few insti ber of scenes, such as:

lead us inexorably to reflect on these ence majors, service learning activi tutions have extra resources to Professional preparation Simply
dimensions of our lives. ties, and so on. spend or space to accommodate put, colleges and universities educate

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POINT OF VIEW

Integrating Health into the Curriculum


Examples from PHHE
Founded in 1995, AAC&Us Program fo r Health and Higher Education (PHHE) was inspired, in part, by the success of a program at Rutgers University. Over the I
last nine years, more than 3,000 Rutgers students have been enrolled in HIV, Biology, and Society, a course that teaches biology through inquiry into and dis-1
cussion about HIV/AIDS and its social impacts. Further, various academic departments have developed related courses of their own, each one focusing on j
some aspect of HIV such as the economics of AIDS research, the global impact of the AIDS pandemic, representations of AIDS in the arts, and so on. |
With support from the U.S. Centers for Disease Control, PHHE has worked with twenty-six colleges and universities as they have developed their own strate-1
gies for integrating issues of health and HIV in particular into the undergraduate curriculum. Heres a sampling of what our partners have accomplished.

Instructors in the freshman writing program nars, with HIV/AIDS serving as a common es from a variety of disciplines, strengthened

at the University of Maryland-Baltimore theme. The university aims to make the study relationships between academic and student

County developed semester-long collabora of important public health issues a unifying affairs, and mounted new courses focused on

tive projects on HIV and related health issues part of the general education program. health and HIV.
and then distributed a collection of the result The State University o f New York at Stony Faculty and administrators at Madonna
ing student work. Course materials were also Brook developed a federated learning com University (MI) developed a series of inter-!
shared with writing program directors in aO munity (FLC) focused on HIV and health, disciplinary courses in history, biology, and|
colleges and universities in Maryland. using the theme to integrate nine courses. literature, focusing on topics such as med

At Jacksonville University (FL), a biology Data comparing two groups of pre-medical ical ethics, public health, and risk-taking

professor created a multidisciplinary honors students showed that those enrolled in a behavior on college campuses. Further, 4.

course. The M any Faces o f AIDS, featuring linking seminar on HIV demonstrated student-led group produced a program oil

contributions from fourteen faculty members, higher academic gains than those not HIV disease for the colleges local cable tele|

and cooperating professors incorporated lec- enrolled in the program. vision program, syndicated on the Catholic-

tures/programs on HIV in their own courses. Cable Network.


Prince Georges Community College (MD)
Freshman seminar students at Frostburg developed a program that invites community- And at the City College of the City

State University (MD) developed individual based organizations to visit and share University o f New York, the vice president

research projects, made in-class presentations, resources on the campus in order to bring for student affairs led efforts to ensure that

and led discussion on topics connecting HIV attention to HIV and other important health all first-year students would participate in

to course work in a variety of fields. For issues in the area. And the colleges nursing classroom-based discussions of health and

example, art students considered the AIDS program organized a series of public lectures decision making. This was supplemented by

Memorial Quilt, and psychology students on the scientific, sociological, legal, and ethical a health fair, held in partnership with local

studied adolescent risk-taking behavior. aspects of the HIV epidemic. community organizations, offering counsel
ing and health services as well as giving stu
At Millikin University (IE), a professor of At the University of Arizona, a team from the
dents information on service learning
nursing has led thirty faculty members in Southwest Institute for Research on Women
opportunities.
developing a series of interdisciplinary semi created a planning initiative that linked cours

For complete descriptions o f these and other PHHE projects (including syllabi, contact information, and more), please visit the PHHE Web pages at
www.aacu-edu.org, or call the program office at 202 884-7433.

6 AAC&U peerReview SPRING 2000 Association of American Colleges and Universities


POINT OF VIEW
d

the health workforce, including the powers and frailties that come pounding in the skull and a fire in can speculate that the overall effect
nurses, doctors, teachers, medical with longevity. the bowels.^ on classroom learning of our stu
researchers, and more. The health of student bodies, dents personal health concerns and
Other bodies, and the student especially, has a profound impact on crises is of enormous significance.
Disciplinary concerns and re
body in particular Whatever the learning. By way of illustration, my This list is partial, personal, and
search questions In addition to
benefits of gathering young adults colleagues at the Rutgers University arbitrary. But if health is present on
the obvious bio-medical and public
together on a campus, we must rec health center once counted the preg our campuses in so many ways, and
health studies, many policy-oriented
ognize the pathologies associated nancy tests they had performed dur if it bears such weight in our stu
projects and humanistic lines of
with residential colleges. Consider ing the year (data collection that dents lives, then dont we have a
inquiry have to do with health-relat
the data (see pages 15-17), for would be less meaningful today, responsibility not only to provide
ed issues.
example, suggesting that nearly half given the current availability of adequate health information and
Cultures and cosmologies Ideas of all white, male college students home pregnancy kits). Of some services but also to give health a
of health help define the cultures are drunk once a week; that one in 13,000 women on our campus, more significant place in the undergrad
and cosmologies in which we live.
For example, think about how it vio
lates some innate sense of justice
and order when an illness or acci
dent strikes such a young person
as one of our students. Disease and
death are the stuff of poetry and rit
ual, just as much as they are objects
of laboratory work or philosophical
speculation.

Families and communities


Health defines the familial and com
munity relationships that enable
people to go to college, or that enable
colleges to be created and sustained
in the first place. And, quite often,
five women attending college will than 2,000 had cause to be tested, uate curriculum, the central locus
health problems overtake us, upset
experience date rape; and that and one third of that number turned of our work?
ting our carefully planned syllabi,
some 10 percent of college students out to be pregnant. Consider the
stressing our finances, testing our
morals, and even shutting down our
have actively considered suicide. amount and type of distraction rep What's standing in
dormitories and campuses.
Add to these the broad category of resented by these figures. And then our way?
stress-related conditions, such as theres the time and emotion To use a phrase coined by Carol
Our own bodies For example, our the effects of prejudice and political Schneider and Robert Shoenberg,
involved in pregnancy, not only for
aging professoriate certainly is get marginality, which James Baldwin the management of higher educa
these students but also for their
ting older, with all that entails in a described as some dread, chronic tion involves many habits hard to
friends, roommates, and sexual
culture that is youth-obsessed, body disease, the unfailing symptom of break, such as the guarding of dis
partners. Given what it takes to man
conscious, and increasingly aware of which is a kind of blind fever, a ciplinary boundaries and the insis-
age just this one situation alone, we

Association of American Colleges and Universities AAC&U peerReview SPRING 2000 7


tence that the course is the only the central mission of higher educa included in, for example, the fresh whove enlisted in the war on
possible unit of study. As regards the tion (learning, teaching, and man program, it tends to be treated drugs have not themselves strug
curricular integration of health, research) to one if its auxiliary ser either as consumer information or gled to overcome an addiction). In
though, our bad habits tend to be vices, namely the college nurse or instruction on the disease-of-the- short, if were going to consider the
not managerial but conceptual. For doctor or health service. week. But a curricular focus on ethical dimensions of health, then
example: health could be used to bring togeth we need to think carefully about the
We tend to overemphasize per
er parts of the general education ways in which our health behaviors
We tend to confuse health with sonal and underemphasize
program, as well as to invite connec earn us virtue or shame.
health care: If there is one epidemic social determinants of health:
tions between classroom work and
disorder that stands in the way of the Our own choices do matter as
campus life, or to help create a cam What can we do?
approach advocated here, it is that so regards our health, but they arent
pus community, one founded on The work of the last four years has
many of us seem programmed to the only things that matter. We tend
common intellectual experiences. taught my colleagues and me much
equate health with health care (or to think of health one person and
about the challenges of integrating
sickness care as Joseph Califano* one body at a time. But the truth is
We tend to moralize health: health into the undergraduate cur
has called it). When we hear the word that this view obscures larger forces
Surely, there are moral dimensions to riculum. But this work has also
health, we immediately think of (having to do with ones race and
the choices we make about our proven to be immensely rewarding
sickness. When we think sickness, class, or where one lives, or what one
health and that of others. But we and rich with opportunity. And so Td
we think treatment and remedies. does for a living, for example) that
tend to moralize health behaviors like to bring this essay toward a con
And when we think treatment, we affect ones lifes chances.
unfairly (making pariahs out of clusion by focusing not on that
think clinical care. And when we We tend to leave the complex task smokers, for example), harming our which stands in our way but, instead,
think clinical care, we think campus of integrating mind and body to opportunities for understanding on a few of the things we can do to
health care providers (and when students themselves: True, we are them. Conversely, we often claim benefit from of this approach:
those health care providers think all responsible for making sense of moral superiority on account of our
We can question our assumptions
health, chances are theyll think our own jumble of academic and life good health, even if we havent been
about health: As faculty and
about asking for more resources!). experiences, but teaching surely can morally tested (we can presume, for
administrators, we often sing happy
Thus, a circuit is wired directly from help us in that effort. When health is example, that many of the people
little tunes about the health of our
students. Frustrated by our inability
to control their risk-taking behavior,
for instance, we conclude that young
people simply believe themselves to
be invincible, and this conclusion
absolves us of the need to better
understand their lives. Or, converse
ly, we presume that the absence of an
obvious disability or sickness, or the
appearance of a fit body, means that
our students have no health con
cerns, or are not at risk. But, of
course, some very fit people do some
very unhealthy things, and some

8 AAC&U peerReview SPRING 2000 Association of American Colleges and Universities


POINT OF VIEW

people who appear to be sick may sort of work? somebody asked. The one. But we ought to admit the pos good of others, or as freedom from
choose to define themselves as group mostly women respond sibility that some forms of assess bigotry, ignorance, or oppression.
healthy, confounding the usual dis ed enthusiastically. Indeed, we ment can inhibit innovation. And if But we can and should also
tinctions. In short, the cultural mean agreed that the breast would make we make the effort to integrate a describe it in terms of our common
ings and campus practices related to for a remarkable interdisciplinary topic such as health into the curricu health.
health are so knotty and interesting topic, encompassing biology, history, lum, then we need to make an equal I hope that what I have written
that we have much to learn simply by art, anthropology, marketing, you effort to design assessments that are provokes and supports considera
examining our cliches. name it. Yet, no one had ever heard of both rigorous and appropriate. tion of this idea, at least. Health is
such a course, and some of us doubt surely one of those sprawling ques
We can encourage students to
Restoring our health
ed that one could survive on most tions that give rise to what we call
study the health issues that inter Thinking back to that old confession
campuses, given the likelihood of liberal learning, and I believe that it
est them: Of course, this suggestion al rubric, we might be inclined to
public ridicule (despite the fact that should have a more prominent place
merely restates a bit of pedagogical think its too bad that there is no
Madison Avenue teaches a version of in the work that we do. D
wisdom that dates back at least to higher power for curricular improve
this course every day, in magazine
the Progressive Era. But it is worth ment, one who could give us absolu
ads and television commercials). It
repeating, since much of what pass occurred to me that these sorts of
tion for our sins and return to us our References
health, even temporarily. It would be 1. The Book o f Common Prayer. New York: The
es for health education amounts to speculations alone could fill a whole Church Pension Fund, 1945. p. 6.
the providing of facts anatomical nice if we could restore ourselves 2. Baldwin, James. Notes o f A Native Son. Boston:
years worth of undergraduate learn
structures, biological processes, and simply by recognizing our failings. Beacon Press, 1984, p. 94. The passage con
ing. I would argue, in fact, that great tinues: Once this disease is contracted, one
so on even though students them Academe is not religion, of can never be really carefree again, for the
educational opportunities are to be
selves often have an intense and course. But many of us do claim fever, without an instants warning can recur
found in such taboo topics. As a at any moment. It can wreck more important
immediate interest in health issues. membership in a community that
wonderful fragment of Sapphos things than race relations.

The study of health, as I conceive it, has put faith of a sort in liberal edu 3. Schneider, Carol G. and Robert Shoenberg.
advises, however: If you are squea Contemporary Understandings o f a Liberal
demands both an interdisciplinary cation. To be sure, we dont rest on
mish, dont prod the beach rubble.^ Education. Washington, DC: AAC&U, 1998.
approach and also the active partic faith alone: we can and do endeavor 4. Califano, Joseph. Radical Surgery: W hats N extfor
We can assess these efforts rigor to assess and demonstrate the value A m ericas Health Care. New York: Times
ipation of our students in defining Books, 1994.
ously and fairly: Colleagues who of our particular curricular designs,
the questions, methods, and purpos 5. Barnard, Mary. Sappho: A N ew Translation.
teach innovative courses often note reform agendas, and approaches to Berkeley: University of California Press,
es that guide their inquiry. 1994.
that the typical schemes for faculty teaching and learning. However, at
We can cross boundaries: Last evaluation put them at a disadvan bottom, we simply believe in some
summer, I attended a meeting con tage. For example, if you ask students particular habits of mind, some com
cerned with increasing womens par to find answers for themselves, you petencies and capacities that will not
ticipation in the sciences. After a risk being called uninformed. If just secure our students personal
while, the conversation got around to you ask students to take some fortunes but that will also promote
the idea of teaching basic science responsibility for the syllabus, you the general welfare.
through some related issue of pub may be labeled disorganized. To be We can describe this welfare in
lic importance (such as teaching sure, teachers sometimes deserve terms of equality, justice, economic
biology by way of inquiry into the such evaluations. And the transition prosperity, or democratic participa
HIV epidemic). Wouldnt breast from one model of teaching to tion. We can describe it as the free
cancer be a terrific vehicle for this another can certainly be a difficult dom to act for our own good and the

Association of American Colleges and Universities AAC&U peerReview SPRING 2000 9

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