Collaborative Public Health: Lessons Learned from Cologne, Germany

By: Amanda Strausser, MPH, Department of Behavioral and Community Health

Editor’s note: Amanda Strausser is a graduate student working on her Masters in Public Health from the Department of Behavioral and Community Health at the School of Public Health at the University of Maryland, College Park.  She expects to graduate in May 2014.  In May, Amanda went abroad with other students from the school of public health to Cologne, Germany where they attended several public health seminars throughout the city to better understand the health priorities of the Federal Republic of Germany.  Amanda shared this post about her experience.


Being a part of the Department of Behavioral and Community Health has been a wonderful experience for me.  I greatly appreciate all of the opportunities that are available for undergraduate and graduate students. Going to Europe as a graduate student has always been something that I have been interested in doing, particularly as it relates to studying public health.  Therefore, when I received information from the department about an international health course in Germany they were sponsoring, I knew I wanted to go. 

Before going to Germany, I had only been to Europe once – when I was in high school – and I had never been to Germany before.  For the entire trip, we generally stayed within the city of Cologne, which is the fourth largest city in Germany.  It is situated between the Rhine and Rhone River.  

The city is very progressive and liberal in its views, which is reflected in many of his polices—even public health ones.  I appreciated the ease of getting around.  The city boasts an extensive train system, which we utilized for the entire trip.  This is how we made it to each of the seminars, which were located throughout the city.  Cologne has wide array of food options, beautiful outside spaces and a variety of museums, shops, and galleries.  When we were not attending an event associated with this trip, we were busy soaking up the culture!

One of my goals for this international course was to develop a better understanding of the similarities and differences regarding health in Europe and the United States. Europe and the United States have very different understandings of health in terms of their health care system and attitude toward it.  One of the major differences I came to realize is that in the United States we believe that health and being healthy is an individual’s responsibility, but in Germany, they believe in a more collective attitude.  What I mean is that Germans believe they have a responsibility to take care of one another, so even if they are paying into the health care system and are not able to use it, they appreciate knowing that someone else is able to. Also, the collective attitude is an understanding that only so much of our health is under our control.  This attitude became quite clear once we heard about their national health promotion programs.

Six of the students who studied in Germany in May

A group of eight undergraduate and graduate students left for Cologne, Germany in May under the guidance of our department chair, Dr. Elbert Glover, and Dr. Robert McDermott from the University of South Florida. While we were there, we had the opportunity to meet several professors from the University of Cologne, as well as numerous professionals from different public health organizations, businesses, and non-profits around the city.  One of the things I appreciated most about the program is that from day to day, we met with people from all different types of public health.  For example, during the first few days, we went to a waste combustion facility and a water treatment facility.  This was geared toward environmental health, which is a field I am interested in learning more about.  This trip allowed us to learn in a much more hands on manner, while still applying many of the concepts we learned in the classroom.

One of my favorite seminars was about health promotion programs in Germany.  We went to BZgA, which in English translates to "the Federal Center for Health Education."  While we were there, we heard presentations on how Germany is working to generally promote health and prevention programs. We also heard about their Alcohol Prevention and AIDS Prevention Campaigns.  BZgA’s guiding principle is that health promotion and prevention are critical components of the German public health system.  It works to prevent health risks and support health promoting lifestyles. During this seminar, the presenters discussed ways they are using social media and different types of campaigns to target audiences that would benefit most from their programs. For example, in their National AIDs prevention program, they had done extensive mass media campaigns, but after careful evaluations they realized they were not targeting the most at risk populations.  Therefore, they told us how they had to rethink their program.  After discussing this with various members of their target population through interviews and focus groups, they developed new strategies to address this problem. Particularly, they started using social media to reach out to young people.  They also created new promotional materials.  Also, the BZgA trained peer health workers to distribute them at events the target group would most likely attend.

Students take notes during a session in Germany 

While we were there, the BZgA presenters also discussed how their health promotion programs have evolved over the past few decades.  This was really interesting because it showed how they are working to keep their work relevant to the needs of the populations they are trying to target. They also discussed some of the struggles they have encountered with their programs and how they work to address it.  One of these struggles, utilizing technology in the most meaningful way, is something that many organizations and nonprofits in the United States also are trying to deal with.  The BZgA works to overcome this issue by constantly doing research involving their target populations.  They are also constantly evaluating and reevaluating their programs.  

Amanda during her
study-abroad trip in Germany

This seminar was a highlight of the trip for me because I was able to gain a new perspective on how other countries are handling important health issues.  It occurred to me during this presentation how important it is for public health agencies to consider working collaboratively with other agencies in different countries.  There are a lot of similarities in the barriers that we all are trying to overcome when it comes to different health issues.  Some of the approaches Germany is taking to deal with alcohol abuse and AIDS prevention are things that the United States could adopt.  The United States could conduct more thorough and frequent evaluations to be sure we are targeting the right populations and accomplishing the goals of the campaign.  I think it would be great if we could have peer educators be a part of a national program in the way that the peer educators promote AIDS prevention in Germany. We need to begin to learn from one another.  After attending this study abroad program, I have learned that when I am doing research, I will look at different practices and approaches other countries have taken to deal with an issue and try to adopt some of their successes to what I am doing.  

This was a really beneficial experience for me and the other students who attended this trip! It allowed us to take a lot of the things we learn in the classroom and apply them to real world situations. We gained a new international perspective on public health! I believe that because of this trop, I have a better understanding of international public health.  This will allow me to better handle the variety of people and situations I will encounter as a community health educator.  I also understand some of the similarities and differences between the United States and German health care systems and their approach to Public Health.  It is from these similarities and differences, I am able to better understand and appreciate the world around me!  

photos courtesy of UMG Germany Flickr page (umd.germany)