The New Public Health Generation: A Sales Pitch for Governmental Public Health

During my fellowship year at the de Beaumont Foundation, I have spent my time discovering the functions, challenges, and value of governmental public health, as well as considering whether health departments are my next career move. I’m the first to admit that working for the government, especially state or local health departments, doesn’t have the exciting, magnetic pull of some of the interesting entry level positions at policy advocacy groups, consulting firms, and innovative non-profits.

Luckily, I had the chance to explore my hesitations about governmental public health with Dr. Mike Fraser, the Executive Director of the Association of State and Territorial Health Officials (ASTHO) . I sat down with him to ask some questions about the field and future workforce trends.

As the Executive Director of ASTHO, Dr. Fraser represents and supports state health officials across the country. My big question for Dr. Fraser was this: “Why, with such an uncertain financial, political future, should millennials join the governmental public health workforce?” Dr. Fraser reframed the question as a matter of responsibility and social good. If we want to live in a society where people are able to live, work, play, and raise families in healthy environments, government is the best entity to bear the responsibility of that ideal. There is no one else. The way Dr. Fraser puts it, government is a natural place for young people who believe in the common good, which is a compelling motivation for millennials like myself.

When I asked about future trends in public health, Dr. Fraser described his work with state health agencies as making the “invisible, visible,” because public departments are the hidden connective tissue that make our communities livable, from disease surveillance and vaccinations, to progressive improvements in transportation, housing, and food access. We eat, travel, and interact with other people every day without considering the public health departments that make our lives healthy and safe. Dr. Fraser’s, and ASTHO’s, role is to strengthen the voice of governmental public health and change the public perception of health.  Ideally, when people think about ‘health’, they will think less about pills and procedures and more about all the things that make us truly healthy: clean air, economic opportunities, access to healthy foods, safe outdoor space, and more. These are the things that governmental public health takes responsibility for creating, the invisible work that should become visible so that public health has the credibility and investment to do our job. Taking this perspective, I am excited to potentially join agencies that take more responsibility for making people’s lives better.

There is work to be done in public health in America and millennials have the energy, ingenuity, and passion to do it. However, governmental public health has a reputation for bureaucracy, low-paying jobs, and slow hiring processes that discourage young workers. Nevertheless, these less-than-appealing qualities can be mitigated by the powerful draw that meaningful work with a large social impact has on young workers.

Based on my time at the de Beaumont Foundation, and my conversation with Dr. Fraser, I have a sales pitch. Millennials should work in governmental public health agencies because they:

  • Are increasingly strategic in tackling public health problems at their roots and rebalancing the scales of prevention vs. treatment
  • Are working more with other sectors, both cross-jurisdictional in government and with the business, nonprofit, and philanthropy sectors
  • Need passionate people working on the inside
  • Are a place for people who believe in the common good and are passionate about social change and healthy communities

Dr. Fraser mentioned outright that he doesn’t believe in labeling the different generations, due to inaccurate stereotypes. He thinks that a person’s interests and passions come from their lived experiences- and I couldn’t agree more. My own experiences have shown me that the country needs a stronger, vocal, and visible governmental public health, which means that governmental public health needs more young professionals to join up. I haven’t quite made up my mind if I will end up in governmental public health, but I am much more interested than before.

***

This year I am blogging about my experience as a fellow and what it means for the millennial generation to join and change the public health landscape. I will grapple with the changing public health workforce, interview leaders in and out of the field, and discuss the future of public health as my generation sees it. Follow along!

de Beaumont & ASTHO Announce Winners of First-Ever PH WINS Challenge

This article was also posted here

Earlier this summer, ASTHO partnered with the de Beaumont Foundation to launch the first-ever national “Public Health Workforce Interests and Needs Survey (PH WINS) Model Policies and Practices Challenge.” As part of the PH WINS Research to Action initiative, this challenge highlights workforce innovations that are changing the public health field and demonstrating a strategic investment in the future of the national public health workforce. ASTHO and the de Beaumont Foundation issued the PH WINS Challenge to a range of governmental health organizations, including local, state, and territorial health agencies. These organizations competed to have their most successful and transformative workforce development programs recognized as models in their fields and to win one of three $10,000 prizes—best state or territorial, best local, and best overall policy.

ASTHO is proud to announce that the Arizona Department of Health Services, the Lawrence-Douglas County Health Department in Kansas, and the Ohio Department of Health are the winners of the inaugural PH WINS Challenge. Each of these departments and agencies has shown an outstanding commitment to supporting the public health workforce’s increasingly diverse populations. Through each program, these organizations have provided their workers with the training, tools, and development opportunities to best support the changing health needs of their target communities.
Below are quick summaries of the winning submissions. Each winner’s program tackles some of the major support gaps identified by state, territorial, and local public health officials in the 2014 PH WINS, including childcare programs, performance assessment supports, and long-term onsite management training programs.

Best State
Arizona Department of Health Services: Infant at Work Program

As workplace and childcare approaches have evolved to include more working mothers and fathers, the Arizona Department of Health Services (ADHS) saw the need to cater to the working parents in their workforce. ADHS’s Infant at Work program began in 2000 as a way for mothers to breastfeed their infants until the age of six months old at the workplace. The program has numerous benefits, including saving working parents money on core expenditures associated with raising children; fostering a cultural shift in the ADHS approach to working parents and giving them the flexibility to provide their children with the best possible care; and increasing work-life balance and satisfaction for working new parents.

The Infant at Work program has taken off and was endorsed by Arizona Gov. Doug Ducey. The guidelines prioritize employee needs and provide a way for agencies to retain employees.

Best Local
Lawrence-Douglas County Health Department of Kansas: Performance Appraisal System Approach

Feedback, empowerment, and accountability are key to improving worker morale and productivity. To improve employee-supervisor relations and advance the performance of the overall workforce, the Lawrence-Douglas County Health Department (LDCHD) recently developed a performance appraisal system (PAS) wherein supervisors work with their employees to identify professional goals and accountability measures to track performances. This system has allowed supervisors to gather employee input as well as provide honest feedback to employees.

Under PAS, supervisors utilize a coaching model centered on adaptive, rather than technical, goal-setting in which supervisors and employees together create personal development plans focused on staff development and growth. Benefits of this model include providing the LDHCD workforce with the opportunity to attain new skills like budgeting, program management, and systems-thinking; higher rates of workplace satisfaction; proactive and responsive guidance by supervisors for their employees; and active, healthier involvement in the workplace.

Best Overall
Ohio Department of Health: ODH-U Program

Fostering a culture of learning is not enough: proactive workforce development programs should also provide clear pathways and opportunities for advancement. The Ohio Department of Health (ODH) established the ODH-U program in response to employees’ desires to develop the leadership and management skills they need to advance their careers.

ODH-U is an onsite management training program that provides eligible candidates with a year-long course focused on administrative, technical, and strategic skills development. The program offers two pathways for selected employees. The first track requires employees to participate in real workplace-lead work and management training classes with other participants. The second track offers a more streamlined experience that replaces direct on-site management training with an education experience elsewhere for participants who do not have the scheduling flexibility to take group classes.

Each of these winning submissions bear out the importance of collecting data on current workforce development issues and trends. Approximately 38 percent of the current public health workforce intend to leave their jobs in governmental public health by 2020. Moreover, 57 percent of state health agency employees report being recognized for their achievements, and only 45 percent report that their training needs are assessed. The Arizona Department of Health Services, the Lawrence-Douglas County Health Department of Kansas, and the Ohio Department of Health have acknowledged these gaps and are revolutionizing the way public health approaches workforce development and support. These organizations embody the mission of the PH WINS Challenge by meeting public health officials where they are and helping them get to where they need to be in order to promote better health outcomes for all.

The PH WINS Challenge received 16 submissions representing nine states and six local health departments. Applications covered a wide range of content; in addition to the topics above, other applications addressed student internship programs, recruitment practices, leadership development, and employee orientation and onboarding, among others. Ultimately, ADHS, LDCHD, and ODH emerged as model programs; however, each of the 16 submissions indicates the public health field’s clear commitment to investing in its workforce in new, innovative ways.

Learn more about the model policies and practices, access some of the submissions from the challenge, and stay tuned for the 2017 PH WINS survey launching the week of Sept. 25.

The New Public Health Generation: I just got my MPH, now what?

In May 2017 I added six letters to my name, “MPH, CPH” to show that I have the degree and the certifiable core skills required to join the public health workforce. Armed with my new assorted alphabet, I searched for fellowship opportunities that would expand my skills and perspective beyond my education experience. Ultimately, I accepted the ASPPH Philanthropy Fellowship at the de Beaumont Foundation. I have been on the job for two months. Every single day of these two months, there has been an article, experience, project, or meeting that made me think “Why didn’t I learn this at school??”

I spent the second week of my fellowship at the National Association of County and City Health Officials (NACCHO) annual meeting. During this week, I quickly discovered that public health departments are the most fundamental infrastructure that protects the nation’s health. As a recent MPH graduate, this conference should have been my comfort zone. However, I found myself immersed in discussions about governmental functions, budgets, terms, processes, all of which I had never heard before. I realized that, although I studied public health, my knowledge and experience of public health departments was shockingly limited. I have never stepped foot in a public health department or even considered applying for a job in a health department. I began questioning whether an MPH degree adequately prepares graduates for the governmental public health workforce.

Throughout NACCHO Annual, I was presented with two frameworks that encapsulate the future and purpose of public health departments: Chief Health Strategist and Public Health 3.0.  Chief Health Strategists are health departments that convene hospitals, foundations, community-based organizations, and government leaders to strategically align policy, funds, and programs, in order to create healthy populations and environments. Similarly, Public Health 3.0 describes the responsibility of 21st century public health to make environmental, policy, and system changes that improve population health. It also challenges public health to collaborate across sectors, with business professionals and other government departments. These ideas were aimed at the workforce that was represented at NACCHO, preparing and persuading them to shift their local departments towards this next phase of public health work. Sitting in the audience, I was inspired by these visions for the future of public health.

With a behavioral science and health education concentration, I was trained to plan, implement, and evaluate programs based on behavioral change theories at Saint Louis University College for Public Health and Social Justice. And they trained me well! However, my education did little to prepare me to work in a public health department or understand the cross-cutting role of Chief Health Strategist. This is a problem for the public health workforce. The undergraduate and graduate degrees in public health have drastically grown in popularity, with over 20,000 graduates in 2016, of which less than 1 of 10 intended to pursue a medical degree. With an aging workforce, these graduates will soon be in higher demand. However, the new generation of workers will not be prepared to take on future challenges unless they are trained to work broadly in governmental public health and specifically under the visions like Public Health 3.0.

At NACCHO Annual I met public health officials who were worried about the opioid crisis, vaccination rates, and asthma incidence in their jurisdictions. They should also be worried about the students sitting in public health schools today, who are not learning how to be Chief Health Strategists or work in their departments. As one of the newest members to the public health workforce, I know the new generation of public health workers is motivated to transform our field and the health of our nation, but only if the transfer of knowledge and articulation of our mission reaches us where we are: in school.

***

This year I am blogging about my experience as a fellow and what it means for the millennial generation to join and change the public health landscape. I will grapple with the changing public health workforce, interview leaders in and out of the field, and discuss the future of public health as my generation sees it. Follow along!