Jessie Cheung, Contributing Photographer

Despite being a power player in the national response to the coronavirus pandemic, the School of Public Health has been hobbled by a lack of institutional support — and it just had its worst financial year in recent history.

Recently, the school has played a key role in fighting the pandemic. It recently received an award for technology innovation from the Greater New Haven Chamber of Commerce. The school also developed SalivaDirect testing, a saliva-based coronavirus test that has since been used in labs across the country, and has guided the Connecticut state government in its coronavirus response. But in the last 12 years, the School has balanced its budget once. Aside from 2018, it has been in a deficit every year. This year is the worst, Dean of the School of Public Health Sten Vermund said, with the school being in a “substantial deficit.”

“That we are financially challenged by the COVID pandemic is a bit of an irony,” Vermund said. “It’s a bit of a paradox.”

The School of Public Health is one of the University’s seven self-supporting schools, which means that it pays the central University to use the Yale name and facilities. Along with the School of Nursing, YSPH is one of the least well-endowed schools at Yale. As of last December, Vermund said the school had only 0.6 percent of Yale’s endowment.

This year, Yale raised the dues that YSPH had to pay to the University. The School could not pay the new fees. University Spokesperson Karen Peart said that all schools pay an amount to the central University based on their use of services. The central University may allocate funding for specific programs or for recruitment. The School of Medicine covers any debt at the School of Public Health, Peart said.

“I really hope we’re still here in three years,” Vermund said.

Only about 13 percent of the school’s operating budget comes from endowment income. About 60 percent comes from grant and contract funding, and 20 percent comes from tuition.

The role of grant funding 

Public Health professor A. David Paltiel explained that the School’s income is soft money. Hard-money schools have enough endowment income without faculty members contributing funding. But soft-money schools rely on faculty bringing in grants and tuition — which are less stable than endowment income.

“The school’s finances are shaky at best,” Paltiel said. “Even if they’re good, given the fact that so much of our funding comes from grants, we never know where our next meal is coming from more than about four or five years down the road. We’re making long-term commitments to our faculty and to the University with short-term income.”

Tenured faculty at the School are expected to bring in an amount equal to about 70 percent of their salaries through grant funding.

“There was a lot of stress very early on in this pandemic, where to get the money to support our COVID-19 emergency response,” said Anne Wyllie, associate research scientist in epidemiology and one of the researchers who developed SalivaDirect. “[We were] trying to frantically write grants and get funding just so we could support each other.”

Adam J. Moore MPH ’20, who worked in department chair and professor of epidemiology Albert Ko’s lab and professor Nathan Grubaugh’s lab, said the labs’ principal investigators were constantly writing grants to fund research and to take care of the people working in the labs. Moore also told the News that he struggled to get paid a living wage during this time. 

Publicly, the University praised the labs’ work, which reached national headlines.

“It seems like the University kind of uses us for attention but we weren’t given the funds we need,” Moore said. “It was always a massive stressor that could have been very easily eliminated for us to properly devote our full attention to the research instead of: how are we going to pay people so that they can continue to live?”

Peart said that the School of Public Health has articulated priorities for the University’s upcoming capital campaign, including support for faculty, academic centers and research efforts.

Some significant grants, called R01s, come from large organizations like the National Institutes of Health, according to Cary Gross, a professor at the School of Medicine with an appointment at the School of Public Health. The process of applying for these grants begins a year in advance, and principal investigators often work on multiple R01 grant applications simultaneously.

About 25 years ago, 25 percent of R01 grant applications were approved, Gross said. Now, the number of approved applications has halved, but faculty are still expected to bring in the same amount of funding.

“In the current world it’s so much more competitive, it really leads to faculty burnout,” Gross said. “I think it would be a really good time to revisit the degree to which these funds are flowing from the School of Medicine towards the central university.”

Yale needs bold thinking around public health on the part of the central university, Gross said. “What would be wrong with endowing our School of Public Health in a manner consistent with other schools at Yale?”

An underappreciated field

The field has been underappreciated, which Moore said may be due to the fact that “public health is a success when you never hear about it.” When outbreaks are prevented or squashed early on, professionals seem to have overreacted. After the pandemic ends, Moore questioned whether the school will be forgotten again.

“It’s like if you’re driving a jumbo jet plane, you don’t realize the copilot is important until the pilot gets a heart attack and then all of a sudden you’re going, I guess I should have had a copilot,” Gross said. “If the past six months have not convinced academic leaders across this country that schools of public health are of vital importance to national health, national security, to the economy, then nothing will convince us.”

The School also has a relatively small endowment compared to the other schools in the University. According to Paltiel, public health is not a lucrative field, so alumni may have less to give. In the school’s 105 years, it has only had about 10 donations that are over a million dollars, Vermund said. In recent years, other universities including Harvard and Johns Hopkins have received transformative gifts to their Schools of Public Health, including a $350 million gift to Harvard’s school.

Due to its smaller budget, YSPH is at a disadvantage compared to these well-endowed schools when it comes to recruiting top-tier faculty, said Howard Forman, a professor at the Schools of Medicine and Management with an appointment at the School of Public Health. According to Forman, the Yale School of Public Health can’t make the competitive offers other schools can.

Admissions, financial aid and value of a YSPH degree 

In addition to its limited funding from the University, YSPH lost anticipated tuition dollars because 45 admitted students decided not to matriculate this year — more than double the usual number.

“That is a big financial hit to us,” Vermund said. “We have a very thin margin and when we have too few tuitions we fall into the red.”

Tuition at YSPH costs $47,840 each year, but the school can only afford to provide up to a total of $20,000 in need-based financial aid for the two years a student is there, Vermund said. 

“People personally weigh the worth of their degree versus the debt that they’re going to be in,” Moore said. “Complaining about the lack of financial aid available to students is very common and the continued response from the administration is just we’re doing the best we can but we just don’t have a lot of money and we’re in a lot of debt.”

In 2012, 85 percent of YSPH students received financial aid, according to a graph detailing financial aid at Yale’s graduate and professional schools made by Jackson Higginbottom MPH ’20. Six years later, that number had fallen to 55 percent, while the average at  centrally supported schools hovered at about 89 percent.

In an email to Higginbottom obtained by the News, Vermund said that reducing student debt is the highest development priority for the school. The number of students had risen faster than financial aid support once did, Vermund said, but the school reinvests much of its tuition income back into scholarships.

In the coming capital campaign, the University has prioritized increasing financial aid for graduate and professional schools. Vermund said he is hopeful that potential donors have been inspired by YSPH’s work to make a donation to the school. 

“I’m seeing a potentially rosy future for our school,” Vermund said.

The School of Public Health was founded in 1915. 

Rose Horowitch | rose.horowitch@yale.edu