February 01, 2022 | By Heather Krasna
TAGS: journal, career development, coronavirus
NACE Journal, February 2022
Because of COVID-19, public health has been in the news. However, even now, most people are not aware of what public health is, what their local or state health department does, or what kinds of careers exist in the field. If a student asked you what careers exist in public health or how to find them, would you be able to guide them in the right direction?
The answer to this question is more important than ever as $7.4 billion is being spent over the next few years to bolster the underfunded, understaffed local, state, tribal, and territorial health departments around the United States. As a result, there are new career opportunities for every major and degree level, ranging from associate degree graduates to Ph.D.s.
One way to understand the nature of public health is to imagine a doctor who takes care of one patient at a time. Public health professionals are like that doctor, except that their patient is a whole neighborhood, city, county, state, or even nation. Rather than diagnosing an individual’s disease, a public health professional diagnoses and treats the underlying causes that make a whole community more likely to have higher infant mortality, higher rates of lung cancer, or more opioid overdoses. These causes, or “upstream” factors, could include lack of access to prenatal care or nutritious food, exposure to dangerous air pollution from a nearby chemical plant, or even high rates of unemployment.1 The “treatment” could range from a nutrition program to a new clean air law to a community-based intervention to reduce underlying social or economic inequities.
Until COVID-19, public health efforts were often invisible. It’s easy to see how a doctor fixed your broken arm after a car crash, but it’s harder to see how a public health effort prevented you from being hurt because of a seatbelt law. It’s easy to see how a doctor can treat you for food poisoning and harder to see how public health conducts food and restaurant inspections or requires nutrition labeling, preventing you, and millions of other people, from getting sick.
Public health efforts may be invisible, but every day we benefit from public health policies, programs, and research initiatives.
Public health programs are delivered by a broad range of organizations, including government agencies, nonprofits, academia, and even for-profit corporations. However, certain functions of public health are delivered only by government agencies. These agencies include the 50+ state and territorial health departments and the 2,800 local (city and county) health departments, as well as tribal health departments and the broad range of federal government agencies involved with public health. These are spearheaded by the U.S. Department of Health and Human Services, which is the parent agency of the Centers for Disease Control and Prevention, Centers for Disease Control and Prevention, the Food and Drug Administration, and the U.S. Public Health Service. Additionally, the U.S. Environmental Protection Agency and even the U.S. Department of Defense play important roles.
Some of the essential services provided by government health departments include restaurant inspections; licensing and inspection of day care centers; environmental inspections of beaches, swimming pools, and septic systems; immunization programs and registries; health education and screenings; and screening of sexually transmitted infections. Health departments also provide emergency response, newborn genetic screenings, birth and death records, laboratory testing, disease surveillance, tobacco cessation programs, maternal-child health, and nutrition programs. On the federal level, agencies ensure drugs and medical devices are safe for use, provide funding for research on public health, oversee regulation of toxic chemicals, and more.
Government public health agencies, especially local and state health departments, have been drastically short staffed for decades. Many suffered budget cuts from the 2009 recession and never recovered.2 While spending on medical treatments has risen astronomically, investments in public health have declined. It is estimated that 80,000 new people are needed to join government health departments—and that is not counting those needed to respond to the pandemic.3 That’s a big increase considering that state and territorial health departments employ around 91,500 people and local health departments have around 136,000 full-time equivalent staff as of 2019.4, 5 Even these numbers are likely to be overestimated, because many more staff have left health departments in the last two years due to the stress and burnout caused by COVID-19 response.
Unfortunately, due to this lack of understanding of the importance (and cost savings) of public health, health departments in many parts of the country did not have the technology or staff to respond to the pandemic, leaving the country far less prepared for a public health disaster than other countries with stronger public health systems. In response, new investments are now being made to bolster the public health workforce.
Beyond the meaningfulness of a career where students can see that they have made a positive impact on their community, public health has other benefits.
For example, especially in government agencies, there is often more job security and better benefits than in other fields. In addition, public health professionals can access ongoing, free trainings through public health training centers throughout the country. There are also student loan forgiveness programs, such as the Public Service Loan Forgiveness program and, for individuals in certain fields—including medicine, nursing, and social work—there may be loan repayment via the National Health Service Corps program for those who work in health departments. There also are new initiatives to create loan forgiveness programs specifically for public health workers.6, 7
Considering the broad range of services provided by health departments, there is a huge range of career opportunities in the field. While many other careers exist in public health outside of government, here is a snapshot of the key types of careers in local and state government health departments:
With new investments from the American Rescue Plan to bolster the public health workforce, many new career opportunities are now available for students from a broad range of areas, including:8
For students who are motivated by public service, career services professionals can be a key link to help them explore the many career paths and opportunities available in public health.
1 Social Determinants of Substance Use & Overdose Prevention. Minnesota Department of Health. Retrieved from www.health.state.mn.us/communities/opioids/prevention/socialdeterminants.html.
2 Leider, J.P. (May 20, 2020). New Workforce Estimates Show Public Health Never Recovered From the Great Recession. JPHMP Direct. Retrieved from https://jphmpdirect.com/2020/05/20/new-workforce-estimates-show-public-health-never-recovered-from-the-great-recession-then-came-covid-19/.
3 Public Health Departments Need 80,000 New Employees. But That’s Not Enough for a New Pandemic. Route Fifty, October 13, 2021. Retrieved from www.route-fifty.com/health-human-services/2021/10/80000-public-health-employees-needed/186077/.
4 Association of State and Territorial Health Officials. Workforce Capacity: All States. Retrieved from www.astho.org/profile/#openModal3.
5 National Association of County and City Health Officials. National Profile of Local Health Departments. Retrieved from www.naccho.org/resources/lhd-research/national-profile-of-local-health-departments.
6 Public Service Loan Forgiveness. Federal Student Aid. Retrieved from https://studentaid.gov/manage-loans/forgiveness-cancellation/public-service
7 Loan Repayment. National Health Services Corps. Retrieved from https://nhsc.hrsa.gov/.
8 Association of State and Territorial Health Officials, (May 19, 2021). Issue Brief: Public Health Workforce Funding Available Through the American Rescue Plan and CARES Act. Retrieved from www.astho.org/COVID-19/Public-Health-Workforce-Funding-Available-Through-CARES-ARP/.
9 FY 2022 Americorps State and National Public Health. Americorps. Retrieved from https://americorps.gov/funding-opportunity/fy-2022-americorps-state-national-public-health-americorps.
10 Welcome EIS Class of 2021. Centers for Disease Control and Prevention. Retrieved from www.cdc.gov/eis/index.html.
11 Association of Public Health Laboratories. Laboratory Fellowships. Retrieved from www.aphl.org/fellowships/Pages/default.aspx.
12 HHS Announces $80 Million in American Rescue Plan Funding (June 17, 2021). U.S. Department of Health & Human Services. Retrieved from www.hhs.gov/about/news/2021/06/17/hhs-announces-80-million-in-arp-funding-to-bolster-underrepresented-communities-in-public-health-it-workforce.html.
13 Centers for Disease Control and Prevention. Public Health Professionals Gateway. Retrieved from www.cdc.gov/phap/index.html.
Heather Krasna, Ph.D., M.S., Ed.M., has served as assistant dean of career services at Columbia University Mailman School of Public Health since 2013. In this role, she spearheads efforts to ensure that students and alumni of the school obtain meaningful careers in public health by developing career education programs and building connections with employers. Throughout her 23 years as a career services professional, she has served as director of career services at the University of Washington’s Evans School of Public Affairs as well as internship program coordinator at Baruch College, CUNY.
She earned her Ph.D. in public health at the Care and Public Health Research Institute of Maastricht University in the Netherlands with a focus on public health workforce research; in addition, she holds a Master of Education in adult learning and leadership from Teachers College Columbia University and a Master of Science in nonprofit management from New School University. She is the co-author of 101+ Careers in Public Health, 3rd Edition (2021), and the author of Jobs That Matter: Find a Stable, Fulfilling Career in Public Service (2010).
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