As far back as I can remember, I always wanted a career that would give me the chance to make a positive impact on the lives of others. Maybe it was because both my parents were nurses, so service was in my blood. After three years studying political science, the plan was to go to law school and become a public defender. Then I found public health during the summer of my junior year of college and realized that the marriage of policy and health would allow me to make a difference not just one person at a time, but neighborhood by neighborhood and community by community.
While friends explored consulting companies and nonprofits, I was immediately drawn to governmental public health service. I believed that real change could only be achieved from working inside the system. So, for the first decade of my career, that's what I did.
After interning at the Centers for Disease Control and Prevention, I moved on to leadership roles at the Philadelphia Department of Health, Texas Department of State Health Services, and Georgia Department of Public Health. Throughout this time, whether it was championing breastfeeding, leading statewide needs assessments, or designing materials to aid school nurses talk about obesity, I woke up every morning knowing that the work that I was doing had the potential to make a difference in the lives of an incredible number of people.
After my last blog, Four Things You Never Knew About the Governmental Public Health Workforce and Why You Should Care, a respected colleague emailed me to say that the findings of PH WINS gave pause to his daughter, a college freshman, about pursuing a career in governmental public health.
Yes, we could do many things better, just like every other workplace. It would be a mistake to interpret PH WINS as an indictment of public health, though. Rather, it is a roadmap for growth and improvement.
When you are part of governmental public health, you have the opportunity to do work that is meaningful, important, and irreplaceable. Public health is credited with adding 25 years to our life expectancy. If you look at this gain, the fingerprints of governmental public health - at federal, state, and local levels - are apparent.
There are unprecedented numbers of people graduating with degrees in public health, especially at the undergraduate level, suggesting that the field is experiencing a unique opportunity to infuse new ideas and new blood into our critical work. However, according to the Association of Schools and Programs of Public Health, the vast majority of masters and doctoral graduates do not pursue governmental service.
As a counterpart to my previous blog, I want to make the case for a fulfilling and meaningful career in the service of governmental public health.
1. Your work makes a difference.
According to PH WINS data, when state governmental public health workers were asked why they chose public health as a career, nearly all (90 percent) said it was because they wanted to make a difference. Eighty-four percent also cited the mission of public health.
If you're going into public health to make a difference, you're going to be happy with your choice. Ninety-three percent of the workforce report that their work is important, and nearly three-quarters say that they are inspired to meet their goals at work.
Work in state governmental public health agencies also provides an opportunity to work in mission-driven environments where employees are focused on improving the lives of people in their communities. Take the Georgia Department of Public Health, for example. Its mission is front and center on its website: "We Protect Lives." Eighty-five percent of the workforce nationwide reports understanding how their work relates to agency goals like "We Protect Lives."
If you want to know whether to pursue a career in public health, ask the people who are already there. Public health professionals in state agencies - the ones who are actually experiencing the highs and lows of government service on a daily basis - describe their organizations as good places to work. More than half of them would recommend their workplace to others.
My personal feelings of satisfaction in governmental public health, admittedly anecdotal evidence, were corroborated by the numbers. State health agencies have been successful in creating an environment where employees are engaged, listened to, and respected by their leaders. More than 70 percent report that their supervisors and team leaders support employee development, and 83 percent report that they have good relationships with their supervisors and are treated with respect.
The public health workplace has also distinguished itself in its ability to foster work/life balance. Eighty-four percent of the state governmental public health workforce report that their supervisors support their need to balance work and family issues.
3. Odds are good that your colleagues will share your values and care deeply about their work.
Not only do you get to do important work in governmental public health, you get to do it with people who share many of your core values, chief among which is a commitment to service. Nearly 90 percent report good working relationships with their co-workers, and 82 percent report learning from their co-workers as they do their work.
Past research has shown that government sector workers report greater work effort than private sector employees. When you work at a state health department, you get the opportunity to tackle big societal problems - issues that you care about! That may be why more than 90 percent of state government public health workers report giving their best effort at work every day, and 79 percent report feeling completely involved in their work.
4. Governmental public health is rich with opportunity right now.
According to PH WINS, nearly a fifth of the state agency public health workforce plans to leave in the next year. Nearly forty percent plan to leave by 2020. Coverage of PH WINS in The Pump Handle, HealthIT Interoperability, and Science 2.0 all focused on the coming exodus from the governmental state public health workforce. However, with these departures comes a remarkable opportunity for new policies, new technologies, and new ideas in an environment that is ripe for change and with tremendous potential for advancement and upward mobility.
More people have health insurance than at any time in recent memory, and clinical preventive services are now universally provided by insurers without a co-pay. Healthcare is changing. Public health must also change and evolve, if it is to continue the gains it has previously achieved.
Those of us already in public health know that we have to find the next generation of leaders who are inspired by challenges and driven to lead. Governmental public health can be a place where your opinions will be welcomed, and you will experience significant opportunities to advance, both because you will bring new ways of looking at things and because the demographics are in your favor.
A Life of Service
Governmental public health is not without its challenges. Political infighting and disagreement can often interfere with the best interest of the public's health; gridlock and bureaucracy can slow processes in the face of the need for urgent action. There are challenges that face the state governmental public health workforce, including budget cuts, job reductions, legislative and regulatory changes, and more. We can't ignore these realities, and I don't want to sugarcoat them for you.
The truth is we need you - young people interested in public health and able to not only safeguard the gains we've made over the last half century of progress, but also lead us to future advances. My challenge to public health students is NOT to be scared off by studies like PH WINS that show where we need to improve. To start off with, read this blog from de Beaumont CEO Ed Hunter to learn about what ASTHO and de Beaumont are already doing to address the findings from PH WINS and pave the way for a stronger, more innovative public health workforce.
If you're looking for a career that will challenge you while also providing a life of service and meaning, then I welcome you to a profession that I have never regretted joining: governmental public health.
Brian Castrucci is the Chief Program and Strategy Officer at the de Beaumont Foundation, where he was one of the original architects of the PH WINS project. Brian is currently pursuing his doctorate in public health leadership at the University of North Carolina at Chapel Hill Gillings School of Global Public Health. You can follow Brian on Twitter at @BrianCCastrucci and the de Beaumont Foundation at @deBeaumontFndtn.
If you want to know more about working and succeeding in governmental public health, check out these titles from Oxford University Press - Mastering Public Health: Essential Skills for Effective Practice and Public Health Practice: What Works.